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Case Reports: Novel treatment (new drug/interventions; established drug/procedure in new situation)
Omental patch for lower uterine segment repair during caesarean section
  1. Edward Carter and
  2. Frank Le Bacq
  1. Obstetrics and Gynaecology, Queensland Health, Gympie, Queensland, Australia
  1. Correspondence to Dr Edward Carter; edward.carter{at}health.qld.gov.au

Abstract

Increasing rates of caesarean section have contributed to a higher number of complications such as vesicouterine fistula. A G6P5 woman in her early forties presented for her third elective repeat caesarean section. At the time of delivery, there was uterine dehiscence and the fetus was visible through a large 7×5 cm transparent window in the lower segment. After delivery of the baby, the uterus was unable to be repaired with sutures so an omental patch was fixed on the lower segment to facilitate healing. It is hypothesised that the angiogenic properties of the omentum may have promoted healing of the uterine defect and reduced the risk of vesicouterine fistula by providing a protective barrier. The patient recovered well and by 4 months post partum, her menstrual cycle had returned. Thereby, the use of an omental patch during uterine repair may reduce long-term complications associated with repeat caesarean section.

  • Obstetrics and gynaecology
  • Pregnancy
  • Surgery

https://doi.org/10.1136/bcr-2021-246972

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    Footnotes

    • Correction notice The article has been corrected since it is published. The figure 2 and 3 have been updated.

    • Contributors EHC was author, assistant surgeon. FLB was supervisor, primary surgeon.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.