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Peer-reviewedCC BY-NCJournal of family & reproductive health

Conservative Surgical Management of Post-Cesarean Uterine Incisional Necrosis: A Case Report.

  • Zahra Jahani1
  • Zohreh Jahani2
  • Taraneh Arbabzadeh3
  • Jalal Taghizadeh4
  • Behnaz Nouri1
4 affiliations
  1. 1Department of Obstetrics and Gynecology and Perinatology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  2. 2Department of Biochemistry, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
  3. 3Clinical Research Development Unit, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
  4. 4Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract

Objective

Myonecrosis is a complication of severe endometritis. The usual management of uterine incisional necrosis with dehiscence is hysterectomy. Conservative surgery, which involves wound debridement and resuture, presents a strong alternative to hysterectomy.Case report

In this study, a 27-year-old woman underwent an emergency cesarean section at 37 weeks due to fetal distress after labor induction for severe preeclampsia and intrauterine growth restriction. Five days after cesarean section, the patient developed purulent discharge from the incision, followed by tachycardia, leukocytosis, and fever. Imaging revealed endometritis with peritonitis symptoms. Her condition deteriorated in spite of broad-spectrum antibiotics, requiring an urgent exploratory laparotomy. Necrotic tissue was excised during surgery, and the uterine incision was effectively healed without necessitating a hysterectomy. She exhibited a satisfactory recovery, and a three-month follow-up revealed an unblemished uterus.Conclusion

Uterine incision necrosis can be lethal if not appropriately recognized and treated. Conservative therapy can be a good alternative for properly chosen patients, even though hysterectomy is frequently required. Successful outcomes depend on early diagnosis, cautious patient selection, careful infection management, and surgical debridement. The long-term safety and reproductive implications of conservative treatment require further investigation.

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Cite

BibTeXRIS
BibTeX
@article{jahani2026conservative,
  title = {{Conservative Surgical Management of Post-Cesarean Uterine Incisional Necrosis: A Case Report.}},
  author = {Zahra Jahani and Zohreh Jahani and Taraneh Arbabzadeh and Jalal Taghizadeh and Behnaz Nouri},
  journal = {Journal of family \& reproductive health},
  year = {2026},
  month = jun,
  doi = {10.18502/jfrh.v20i2.22617},
  url = {https://europepmc.org/article/MED/42924304},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Conservative Surgical Management of Post-Cesarean Uterine Incisional Necrosis: A Case Report.
AU  - Zahra Jahani
AU  - Zohreh Jahani
AU  - Taraneh Arbabzadeh
AU  - Jalal Taghizadeh
AU  - Behnaz Nouri
PY  - 2026
DA  - 2026/06/01
JO  - Journal of family & reproductive health
DO  - 10.18502/jfrh.v20i2.22617
UR  - https://europepmc.org/article/MED/42924304
AB  - Objective  Myonecrosis is a complication of severe endometritis. The usual management of uterine incisional necrosis with dehiscence is hysterectomy. Conservative surgery, which involves wound debridement and resuture, presents a strong alternative to hysterectomy.Case report  In this study, a 27-year-old woman underwent an emergency cesarean section at 37 weeks due to fetal distress after labor induction for severe preeclampsia and intrauterine growth restriction. Five days after cesarean section, the patient developed purulent discharge from the incision, followed by tachycardia, leukocytosis, and fever. Imaging revealed endometritis with peritonitis symptoms. Her condition deteriorated in spite of broad-spectrum antibiotics, requiring an urgent exploratory laparotomy. Necrotic tissue was excised during surgery, and the uterine incision was effectively healed without necessitating a hysterectomy. She exhibited a satisfactory recovery, and a three-month follow-up revealed an unblemished uterus.Conclusion  Uterine incision necrosis can be lethal if not appropriately recognized and treated. Conservative therapy can be a good alternative for properly chosen patients, even though hysterectomy is frequently required. Successful outcomes depend on early diagnosis, cautious patient selection, careful infection management, and surgical debridement. The long-term safety and reproductive implications of conservative treatment require further investigation.
SN  - 1735-8949
SN  - 1735-9392
ER  -