Uterine Necrosis Following Conservative Treatment for Postpartum Haemorrhage in A Case and Literature Review

Case Report

Uterine Necrosis Following Conservative Treatment for Postpartum Haemorrhage in A Case and Literature Review

R. Sabiri ^*
K. Benhaddougua
K. Fadil
Z. Lebdaoui
A. Assal
M. Jalal
A. Lamrissi
S. Bouhya

Service de maternité gynecologie obstetrique hôpital mère enfant Abderahim El Harouchi, Casablanca, Morocco.

*Corresponding Author: R. Sabiri, Service de maternité gynecologie obstetrique hôpital mère enfant Abderahim El Harouchi, Casablanca, Morocco.

Citation: Sabiri R., Benhaddougua K., Fadil K., Lebdaoui Z., Assal A., et al. (2024). Uterine Necrosis Following Conservative Treatment for Postpartum Haemorrhage in A Case and Literature Review, International Journal of Clinical and Surgical Pathology, BioRes Scientia Publishers. 1(1):1-11. DOI: 10.59657/ijcsp.brs.24.006

Copyright: © 2024 R. Sabiri, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: June 19, 2024 | Accepted: August 05, 2024 | Published: August 12, 2024

Abstract

Delivery hemorrhage remains the leading cause of death in most countries, including Morocco. Its management must be multidisciplinary and rapid. Uterine compression techniques have not been widely evaluated, but have been rapidly disseminated throughout the world due to their ease of application. Nevertheless, secondary complications have been reported in the literature, including uterine necrosis. We report a case of uterine necrosis following conservative surgical treatment of delivery hemorrhage using a combination of the B-Lynch uterine compression technique and Tsirulnikov triple vascular ligation. The patient presented with sepsis on postpartum day 2, with fever, pelvic pain and a biological inflammatory syndrome that worsened 48 hours later. Pelvic CT showed no enhancement of the myometrium after injection of PDC, suggesting myometrial necrosis. An exploratory laparotomy was performed, which revealed complete necrosis of the uterus.

The surgical technique of uterine compression sutures plays a major role in the therapeutic arsenal of post-partum hemorrhage, enabling the patient's fertility to be preserved, but it also requires maximum caution and monitoring for complications, the most serious of which is uterine necrosis.

Keywords: uterine necrosis; conservative surgical treatment; patient's fertility

References

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