Potential of ultrasound in the evaluation of acute appendicitis during pregnancy: a systematic review and meta-analysis

Objective: To assess the accuracy of ultrasound in diagnosing acute appendicitis in pregnant women. Mechanism: The National Library of Medicine (MEDLINE, 1990-2020), Exccrpta Medica Database (EIVIBASE,1946-2020) and the Cochrane Controlled Trials Register (CENTRAL) were used to extract articles that were published in English. A total of five studies involving 521 patients were selected. The DerSimonian and Laird random-effects model and Quality Assessment Tool for Diagnostic Accuracy (QUADAS-2) were used to analyze the data. Findings in brief: We identified 140 related articles and included 5 articles enrolling 521 patients. The values obtained using ultrasound for appendicitis during pregnancy were sensitivity of 0.62 (95% Confidence interval (CI): 0.43-0.78), the specificity of 0.91 (95% CI: 0.74-0.97), and the Positive Likelihood Ratio of 7.0 (95% CI: 2.5-19.7), the Negative Likelihood Ratio of 0.41 (95% CI: 0.27-0.63) and the Diagnostic Odds Ratio of 17 (95% CI : 6-49). Conclusion: Ultrasound had medium-level sensitivity and high specificity for the diagnosis of appendicitis in pregnant women.