Background: Acute appendicitis during pregnancy is a serious complication because of the difficult diagnosis and increased perinatal morbidity and mortality.
Case: A 29-year-old woman underwent cesarean section and an appendectomy because of clinical symptoms of an acute abdomen and fetal distress.
Conclusion: Acute appendicitis in pregnancy is rare but requires special attention to maternal and fetal morbidity and mortality. In this case, acute appendicitis and peritonitis were associated with uterine contractions and fetal distress. How extrauterine infections may mediate uterine contractions and fetal distress remains unsolved.