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Case Reports: Unusual association of diseases/symptoms
Uterine necrosis during pregnancy following exploratory laparotomy
  1. Anna Hirsch,
  2. Rachel Newman and
  3. Mariam Naqvi
  1. Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA
  1. Correspondence to Dr Anna Hirsch; anna.hirsch{at}cshs.org

Abstract

Uterine necrosis is an infrequent event and is most commonly reported as a complication of interventions for postpartum haemorrhage management. Cases of uterine necrosis in pregnancy are rare. The mainstay of treatment for uterine necrosis is hysterectomy, and the data regarding conservative management are limited. A gravida 3, para 2 presented at 33 weeks gestation with ovarian torsion and underwent an exploratory laparotomy with ovarian cystectomy. The surgery was complicated by excess bleeding, which was controlled with the placement of sutures along the uterine body. She had multiple subsequent presentations for severe abdominal pain without clear aetiology. Four weeks after the initial surgery, she underwent caesarean delivery, at which time uterine necrosis was diagnosed. Her uterus was preserved. She received postoperative intravenous antibiotics and was closely observed. She continued to do well 10 months postpartum. In patients with uterine necrosis during pregnancy who are haemodynamically stable, conservative management may be an option.

  • Pregnancy
  • Materno-fetal medicine
  • Obstetrics and gynaecology

https://doi.org/10.1136/bcr-2022-252273

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    Footnotes

    • Contributors All three authors were involved in the care of this patient during her admissions. AH obtained consent from the patient, reviewed the medical record, drafted the report and incorporated edits to produce the final manuscript. RN drafted sections of the report and contributed edits throughout the writing process. MN oversaw the production of the report, contributed edits and provided expertise and guidance.

    • 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.