title: Medical management of ruptured appendicitis in pregnancy.
abstract: BACKGROUND
  Ruptured appendicitis in pregnancy is an advanced stage of appendicitis that imposes significant maternal and fetal morbidity; the best treatment for the obstetric patient in this situation is unclear.
  
  
  METHODS
  In the first case, a nulliparous woman at 32 weeks of gestation presented with ruptured appendicitis. She was treated nonsurgically with intravenous antibiotics and had an uncomplicated vaginal delivery at term. In the second case, a nulliparous woman presented at 27 weeks of gestation with ruptured appendicitis and was treated nonsurgically with intravenous antibiotics. She had a recurrence of appendicitis at 32 weeks of gestation, and again was treated with medical management. She delivered a viable infant by cesarean at 34 weeks of gestation for breech presentation and preterm labor.
  
  
  CONCLUSIONS
  Similar to in the nonpregnant population, medical management of ruptured appendicitis in pregnancy may be a reasonable treatment option.
authors.affiliation: From the Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Brett C
authors.initials: BC
authors.lastname: Young
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Hamar
authors.forename: Deborah
authors.initials: D
authors.lastname: Levine
authors.forename: Henry
authors.initials: H
authors.lastname: Roqué
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D011181:Postnatal Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D011295:Prenatal Care
chemical_list: D000900:Anti-Bacterial Agents