Treatment strategy for failed repair of uterine rupture: Cleansing an abscess via the cervical Canal

We present a new, conservative treatment strategy for the cases in which an initial repair surgery of uterine rupture failed. In a case presented here, the patient underwent a repair surgery for the uterine rupture that became apparent 4 days after the cesarean delivery, but a part of the wound did...

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Bibliographic Details
Published in:The journal of obstetrics and gynaecology research 2020-07, Vol.46 (7), p.1207-1210
Main Authors: Fukuoka, Yasunori, Katou, Hiroki, Shibata, Takashi, Tokuda, Hisato, Iizuka, Noriaki, Nakago, Satoshi
Format: Article
Language:English
Subjects:
Abscesses
Canals (anatomy)
Cervix
Cesarean section
conservative treatment
failure of repair
Health risk assessment
next pregnancy
Patients
Pregnancy
Rupture
Surgery
uterine artery embolization
uterine rupture
Uterus
Vagina
Wound healing
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Summary:We present a new, conservative treatment strategy for the cases in which an initial repair surgery of uterine rupture failed. In a case presented here, the patient underwent a repair surgery for the uterine rupture that became apparent 4 days after the cesarean delivery, but a part of the wound did not heal and an abscess formed in the surrounding area. The patient had purulent discharge from vagina, which led us to try to insert a Nelaton tube from vagina via cervical canal and to cleanse the abscess cavity. This procedure was successful and the abscess disappeared 38 days later, allowing the healing of the ruptured wound. The patient could deliver a baby 2 years later. Even if the initial repair treatment fails, a possibility of preserving the uterus should be considered for next pregnancy. One of the concrete treatment strategies for this purpose was presented.
ISSN:1341-8076
1447-0756
DOI:10.1111/jog.14265