Vaginal birth following diagnostic vnotes and appendectomy in a pregnant woman: a case report

Abstract

This case report describes the successful use of transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for the diagnosis and treatment of acute abdominal pain in a pregnant woman during the first trimester. A 28-year-old woman underwent diagnostic vNOTES, which revealed acute appendicitis and enabled a successful appendectomy without pregnancy-related complications. The patient experienced an uneventful pregnancy and subsequently delivered a healthy infant vaginally at term. The authors suggest that vNOTES may represent a safe and effective alternative to conventional laparoscopy for selected pregnant patients with acute abdomen, offering favorable surgical outcomes without adversely affecting pregnancy, cervical dilatation, or vaginal delivery. They conclude that this technique may be considered in emergency settings while emphasizing the need for further evidence on its long-term obstetric outcomes.