Diverticulitis in Pregnancy Is Associated with High Complication Rates.

BACKGROUND

National trends toward earlier onset of diverticulitis combined with more advanced maternal age may converge, making diverticulitis an increasingly important etiology of obstetric abdominal infection. However, there is little data on this topic, and no specific guidelines on how to treat pregnant patients with the disease. The purpose of this study was to identify the frequency of hospitalization for diverticulitis in pregnant patients and the common complications associated with this disease process.

METHODS

We conducted a retrospective cohort study using the National Readmissions Database (NRD) to evaluate maternal and fetal complications among pregnant patients diagnosed with diverticulitis. The NRD was queried for all visits in the first 3 quarters of each year, 2016-2019, that included a patient with an International Classification of Diseases-10 code for diverticulitis and pregnancy. These entries were then further investigated for demographics, gestational age, rates of intervention, readmissions, and maternal and fetal complications.

RESULTS

A total of 470 patients were identified with a diagnosis of diverticulitis and pregnancy. Most patients (n = 340, 72.3%) were in the third trimester of pregnancy at presentation. 160/470 (34.0%) of admissions led to fetal delivery within 48 h. Of these, 3.8% of patients (n = 18) had complicated diverticulitis on index admission. The 90-day readmission rate for perforation or abscess was 1.3%. There were no reported maternal deaths. The overall rate of maternal complications was 41.3% and fetal complications was 41%, including a 1.9% rate of fetal loss.

CONCLUSIONS

Diverticulitis is associated with significant rates of maternal and fetal complications when it occurs during pregnancy. Further investigation is warranted to better define the outcomes and guide best practices in this population.