Medical management of ruptured appendicitis in pregnancy

Obstet Gynecol. 2009 Aug;114(2 Pt 2):453-456. doi: 10.1097/AOG.0b013e3181998424.


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.

Cases: 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.

Conclusion: Similar to in the nonpregnant population, medical management of ruptured appendicitis in pregnancy may be a reasonable treatment option.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Appendectomy
  • Appendicitis / diagnosis
  • Appendicitis / drug therapy*
  • Appendicitis / surgery
  • Female
  • Humans
  • Postnatal Care
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / drug therapy*
  • Pregnancy Complications / surgery
  • Prenatal Care*


  • Anti-Bacterial Agents