Pregnancy after repeat surgical delivery in a woman who had a history of reconstructive plastic surgery for uterine suture failures on Day 8 after cesarean section


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Abstract

Background. The problem of treating purulent endometritis after cesarean section remains relevant, since hysterectomy is frequently performed in uterine suture failures, which leads to a woman’s worse quality of life. Timely diagnosis of uterine suture failures makes it possible to perform reconstructive plastic surgery and to preserve the reproductive function. Case report. The paper describes a clinical case of a favorable pregnancy and delivery in a pregnant woman with a uterine suture after three cesarean sections and metroplasty for uterine suture failure in postpartum endometritis. It depicts the complex usage of antibacterial therapy and the intrauterine sorbent VNIITU-1 after metroplasty for postpartum endometritis, which allows the effective elimination of pathogenic microorganisms and local detoxification. The combination application of Zhukovsky uterine and vaginal catheters shows a positive effect in preventing uterine bleeding and pelvic hematomas. Conclusion. An integrated approach to treating postpartum endometritis, by using antibacterial therapy and the intrauterine sorbent VNIITU-1, can improve the outcomes of reconstructive plastic surgeries. The use of Zhukovsky balloon tamponade during delivery in pregnant women with a failed uterine scar after cesarean section permits the amount of blood loss to be reduced during reconstructive plastic surgeries.

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About the authors

Sergey V. Barinov

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: barinov_omsk@mail.ru
MD, Professor, Head of the Department of Obstetrics and Gynecology №2 Omsk, Russia

Tat’yana V. Kadtsyna

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: tatianavlad@list.ru
PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Yulia I. Tirskaya

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: yulia.tirskaya@yandex.ru
MD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Irina V. Medyannikova

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: mediren@gmail.com
MD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Oksana V. Lazareva

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: lazow@mail.ru
PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Yuriy I. Chulovsky

Omsk State Medical University, Ministry of Health of the Russian Federation

Email: akusheromsk@rambler.ru
PhD, Associate Professor, Department of Obstetrics and Gynecology №2 Omsk, Russia

Tamara A. Stotskaya

Perinatal Center, Omsk Clinical Hospital

Email: tamara.stotckaja@yandex.ru
doctor of the Department of Pregnancy Pathology Omsk, Russia

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