title: Concurrent postpartum uterine and abdominal wall dehiscence and Streptococcus anginosus infection.
abstract: BACKGROUND
  Postpartum uterine scar dehiscence is a rare but potentially lethal complication of cesarean deliveries.
  
  
  METHODS
  Concurrent abdominal and uterine dehiscences after cesarean delivery for arrest of descent with chorioamnionitis occurred in a 16-year-old patient after her first delivery. The uterine and fascia incisions were reclosed during exploratory laparotomy. Streptococcus anginosus was isolated from the peritoneal fluid. The patient remained afebrile and was discharged 6 days after relaparotomy and took levofloxacin and metronidazole orally for 5 more days.
  
  
  CONCLUSIONS
  Uterine scar separation needs to be considered in patients with a fascial dehiscence after cesarean delivery for arrest of labor. Selected cases can be managed conservatively (uterine reclosure), but patients should be counseled about the possible need for hysterectomy at the time of relaparotomy.
authors.affiliation: From the Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, New York.
authors.forename: Alejandro D
authors.initials: AD
authors.lastname: Treszezamsky
authors.forename: Danielle
authors.initials: D
authors.lastname: Feldman
authors.forename: Voravut O
authors.initials: VO
authors.lastname: Sarabanchong
mesh_terms: D034861:Abdominal Wall / Q000382:microbiology* / Q000601:surgery; D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001202:Ascitic Fluid / Q000187:drug effects / Q000382:microbiology; D002437:Cefazolin / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects; D002821:Chorioamnionitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D005260:Female; D006801:Humans; D064704:Levofloxacin; D008795:Metronidazole / Q000627:therapeutic use; D015242:Ofloxacin / Q000627:therapeutic use; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D049590:Postpartum Period; D011247:Pregnancy; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D034366:Streptococcus anginosus / Q000187:drug effects / Q000302:isolation & purification*; D013529:Surgical Wound Dehiscence / Q000188:drug therapy / Q000382:microbiology*; D014599:Uterus / Q000187:drug effects / Q000382:microbiology* / Q000601:surgery; D014657:Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D064704:Levofloxacin; D015242:Ofloxacin; D002437:Cefazolin