Uterine incisional necrosis complicating cesarean section.
OBJECTIVE
To establish the clinical features of patients with necrosis of the uterine incision after cesarean delivery because of the paucity of modern reports in the literature.


METHODS
Over a 4-year period, the records of 6 patients with this complication were reviewed.


RESULTS
Three patients presented within 48-72 hours of delivery with clinical features very similar to those of bowel perforation. One patient had fascial dehiscence on day 5 after delivery. Two cases presented 2 and 6 weeks after delivery with postpartum hemorrhage without peritoneal findings. Diagnosis was not made prior to surgery in any case. All patients recovered after hysterectomy.


CONCLUSIONS
While the major risks with this uncommon but important complication are serious infectious morbidity and mortality, in our patients these risks were avoided but at the cost of hysterectomy in a group of young women of low parity. More data in the future might establish a basis for rational management, possibly including conservative surgery in selected cases.
Rivlin
Michel E
ME
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.
Carroll
C Shannon
CS
Morrison
John C
JC
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009336:Necrosis; D011183:Postoperative Complications; D011247:Pregnancy; D014591:Uterine Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014599:Uterus / Q000473:pathology