Medical management of ruptured appendicitis in pregnancy.
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.
Young
Brett C
BC
From the Department of Obstetrics & Gynecology, Division of Maternal Fetal Medicine, and Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Hamar
Benjamin D
BD
Levine
Deborah
D
Roqué
Henry
H
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
D000900:Anti-Bacterial Agents