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Re: Acute Appendicitis at 36.5 weeksFrom: DoctorJoe@aol.comThu Jun 29 12:09:01 2000
In a message dated 6/29/0 10:35:01 AM, you wrote: <<Acute appendicitis at 36.5 wks gestation. Wuuld anyone consider elective Cesarean at the same time to avoid possible wound disruption during 2nd stage labor 3 weeks later?>> I would almost be inclined to simply deliver the 36.5 weeker FIRST, then turn to the appendix. This would avoid prolonged anesthesia and fluid/pressure shifts for the baby in utero, possible uterine infection after the appendectomy, and possible incision problems due to distension in late pregnancy, labor, etc. If you simply do an appendectomy (Open, right? You can't do a laparoscopic on a 36.5 weeker, can you?), I would be exceedingly concerned with the baby's status through the surgery and post-op period, and the chance that there might be adjacent or hematogenous spread of infection. In fact, I'm surprised the initial presentation didn't include preterm labor, along with signs and symptoms of appendicitis... Joe P.
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