The Pregnant Index (PGIndex) has emerged as a groundbreaking diagnostic tool aimed at enhancing the detection of acute appendicitis among pregnant women. With appendicitis being one of the most frequent surgical emergencies faced during pregnancy, the research conducted by the team at Hitit University Faculty of Medicine emphasizes the necessity for accurate and timely diagnoses to mitigate risks associated with maternal and fetal health.
Acute appendicitis is the most common cause of non-obstetric abdominal emergencies during pregnancy, with incidences reported to range between 1:1250 and 1:1500 pregnancies. Despite its frequency, diagnosing appendicitis can be particularly challenging. The overlapping symptoms between appendicitis and normal pregnancy include nausea, abdominal pain, and vomiting, which often lead to misdiagnosis and surgical delays. Therefore, the development of reliable diagnostic tools, like the PGIndex, is critically important.
The study evaluated various laboratory parameters collected from 120 patients over the span of six years, categorized as healthy pregnant women, healthy non-pregnant women, pregnant patients with appendicitis, and non-pregnant patients with appendicitis. Notably, white blood cell (WBC) counts, neutrophil-lymphocyte ratios (NLR), and C-reactive protein (CRP) levels were significantly different across these groups. The PGIndex, defined as PGIndex = NE*CRP/MPV, was found to be particularly effective, demonstrating standout performance with 73.3% sensitivity, 96.7% specificity, and 85% overall accuracy.
Utilizing the receiver operating characteristic (ROC) curve analysis, the researchers identified the optimal cut-off value for PGIndex at 10.62. This threshold indicates not only the presence of appendicitis but significantly enhances the likelihood of accurate diagnosis, proving to be 78.75 times more predictive for appendicitis when exceeded.
Importantly, the study concluded, "This is the first study using the Pregnant Index in pregnant women to diagnose appendicitis," indicating its potential as a fundamental diagnostic parameter within obstetric care. The method is straightforward, cost-effective, and does not necessitate advanced imaging methods—making it accessible for clinical implementations.
By confirming the index's effectiveness, the research facilitates quicker surgical decision-making processes, which are imperative for preventing severe complications like maternal and fetal morbidity. The authors encourage future studies to validate these findings on larger scales and explore integrating the PGIndex systematically within clinical practices.
With new insights from this research, healthcare professionals can approach the management of pregnant patients with abdominal pain with greater confidence. By adopting effective diagnostic tools, they stand to significantly improve care quality and outcomes.