A life-threatening abdominal abscess secondary to forgotten placental tissue during cesarean section: A case report

Abstract

Techniques for cesarean delivery, reliable anesthesia, blood products and antibiotics has led to the expansion of indications for cesarean birth. Nowadays, to be comfortable in anesthesia, medicine and materials used in, severe sterilization techniques, advances in surgery and postoperative care were reduced mortality and morbidity. However; caesarean section still include infection, bleeding, need for transfusion, thromboembolic risks of a longer stay in the hospital, later to be healing, but rather risks, such as the withdrawal of the pain continues. Postpartum hemorrhage inside the remaining placentas compared to normal primary complaint is that too much. At the same time ultrasonographic examination of the uterine involution does not occur, the uterus larger than normally. The aim of this case report, and the absence of postoperative bleeding, complete involution of the uterus that have not been diagnosed, and threatened her life was to present a case which is characterized by abdominal abscess. J Clin Exp Invest 2013; 4 (4): 542-545

Keywords

• Cesarean operation, the placenta, intra-abdominal abscess

A life-threatening abdominal abscess secondary to forgotten placental tissue during cesarean section: A case report

Öz

Sezaryen tekniğindeki gelişmeler, güvenilir anestezi uygulamaları, kan ürünleri ve anbiyotikler sezaryen ile doğum endikasyonlarının genişlemesine sebep olmuştur. Günümüzde anestezinin konforlu olması, kullanılan ilaç ve malzemeler, ciddi sterilizasyon teknikleri, cerrahi ve postoperatif bakımdaki gelişmeler sezaryenlere bağlı mortalite ve morbiditeyi azaltmış olmakla birlikte halen enfeksiyon, kanama, transfüzyon ihtiyacı, tromboembolik riskler, hastanede daha uzun kalma, iyileşmenin daha geç olması, daha çok ağrı çekilmesi gibi riskler devam etmektedir. Doğum sonrası içerde kalan plasentalarda öncelikli şikayet normale göre kanamanın çok fazla olmasıdır. Ultrasonografik muayenede uterusun involüsyonundaki gecikmeye bağlı olarak uterus normalden büyüktür. Bu olgu sunumunda postoperatif dönemde kanama olmaması ve uterusun involusyonunun tamamlanması nedeniyle tanı konamayan ve hayatı tehdid eden abdominal abse ile prezente olan bir olguyu sunmayı amaçladık.

Anahtar Kelimeler

• Sezeryan operasyonu, plasenta, batın içi apse

References

1. Lilford RJ, van Coeverden de Groot HA, Moore PJ, Bingham P. Relative risks of ceserean section and vaginal delivery: a detailed analysis to exclude the ef- fects of medical disorders and other acute preexist- ing physiological disturbances. Br J Obstet Gynecol 1990;97:883-892.
2. Kurtoğlu Z, et al. Plasenta previa perkretanin konser- vatif yönetimi: İki olgu sunumu. Perinatoloji Dergisi 2011;19:145-148.
3. Yancey MK, Clark P, Duff P. The frequency of glove contamination during cesarean delivery. Obstet Gyne- col 1994;83:538-542.
4. Watts DH, Hillier SL, Eschenbach DA. Upper genital tract isolates at delivery as predictors of post-cesar- ean infections among women receiving antibiotic pro- phylaxis. Obstet Gynecol 1991;77:287-292.
5. Henrich W, Fuchs I, Ehrenstein T, Kjos S, Schmider A, Dudenhausen JW. Antenatal diagnosis of placenta percreta with planned in situ retention and methotrex- ate therapy in a woman infected with HIV. Ultrasound Obstet Gynecol 2002;20:90-93.
6. Baksu A, et al. The effect of placental removal method and site of uterine repair on postcesarean endome- tritis and operative blood loss. Acta Obstet Gynecol Scand 2005;84:266-269.
7. Ekoukou D, Tin LNW, Nere MB, Bourdet O, Elalaoui Y, Bazin C. Placenta membranacea. Review of the lit- erature, a case report. Gynecol Obstet Biol Reprod (Paris) 1995;24:189-193.
8. Breen JL, Neubecker R, Gregori CA, Franklin JE. Pla- centa accreta, increta and percreta: a survey of 40 cases. Obstet Gynecol 1977;49:43-47.

9. Hemminki E, Merilainen J. Long term effects of ceser- ean sections: ectopic problems and placental prob- lems. Am J Obstet Gynecol 1996;174:1569-1574.
10. Baxi LV. The effect of manual removal of the pla- centa on post-cesarean endometritis. Obstet Gynecol 1996;87:799-800.
11. Magann EF, Chauhan SP, Martin JN Jr, Bryant KS, Bufkin L, Morrison JC. Does uterine wiping influence the rate of post-Cesarean endometritis? Matern Fetal Med 2001;10:318-322.