Journal of family & reproductive health
Conservative Surgical Management of Post-Cesarean Uterine Incisional Necrosis: A Case Report
By Jahani Z, Jahani Z, Arbabzadeh T and 2 others.
Abstract
Objective
Myonecrosis is a complication of severe endometritis. The usual management of uterine incisional necrosis with dehiscence is hysterectomy. Conservative surgery, which involves wound debridement and resuture, presents a strong alternative to hysterectomy.
Case report
In this study, a 27-year-old woman underwent an emergency cesarean section at 37 weeks due to fetal distress after labor induction for severe preeclampsia and intrauterine growth restriction. Five days after cesarean section, the patient developed purulent discharge from the incision, followed by tachycardia, leukocytosis, and fever. Imaging revealed endometritis with peritonitis symptoms. Her condition deteriorated in spite of broad-spectrum antibiotics, requiring an urgent exploratory laparotomy. Necrotic tissue was excised during surgery, and the uterine incision was effectively healed without necessitating a hysterectomy. She exhibited a satisfactory recovery, and a three-month follow-up revealed an unblemished uterus.