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Concurrent Postpartum Uterine and Abdominal Wall Dehiscence and Streptococcus anginosus Infection

Treszezamsky, Alejandro D. MD; Feldman, Danielle MD; Sarabanchong, Voravut O. MD, MPH

doi: 10.1097/AOG.0b013e31821619e9
Case Reports
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BACKGROUND: Postpartum uterine scar dehiscence is a rare but potentially lethal complication of cesarean deliveries.

CASE: 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.

CONCLUSION: 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.

Concurrent abdominal and uterine wound dehiscence should be considered in the differential diagnosis in the setting of postcesarean fever and wound discharge.

From the Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, New York.

Corresponding author: Alejandro D. Treszezamsky, MD, 1176 Fifth Avenue, Box 1170, New York, NY 10029-6574; e-mail: alejandro.treszezamsky@mssm.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 The American College of Obstetricians and Gynecologists