Management of pelvic abscess during pregnancy: A case and review of the literature

Cases of pelvic or abdominal abscess complicating pregnancy are rare. Noninvasive diagnostic techniques including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) have enabled early diagnosis of this unusual complication of pregnancy. We describe a patient in whom the diagnosis of a pelvic mass was made by sonography and MRI at 25 weeks' gestation. At laparotomy, a pelvic abscess was partially resected and drained. Two weeks later when the patient again became symptomatic, a recurrent pelvic abscess was detected by CT and treated with intravenous antibiotics and CT-guided transcatheter drainage. The patient's recovery was thereafter uncomplicated and she delivered a healthy male infant by elective repeat cesarean at 38 weeks' gestation. The literature concerning pelvic and abdominal abscesses during pregnancy is reviewed. The potential advantages of imaging-guided, percutaneous transcatheter drainage for the treatment of such patients are emphasized.