title: Uterine incisional necrosis complicating cesarean section.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, USA.
authors.forename: Michel E
authors.initials: ME
authors.lastname: Rivlin
authors.forename: C Shannon
authors.initials: CS
authors.lastname: Carroll
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: 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