Conservative Management of Postcesarean Uterine Dehiscence: A Dilemma for Obstetrician

Puerperal sepsis remains the most important cause of preventable maternal death worldwide.The surgeon is left with a dilemma: Remove the infection source (uterus) to preserve the life of the patient at the cost of her fertility, or preserve the uterus and fertility but risk worsening infection and possible death for the patient.We are going to describe a rare case in which conservative management was done in case of a patient with purpureal sepsis with uterine dehiscence after an emergency cesarean section.A 24-year-old primigravida developed abdominal distension postoperatively along with puerperal sepsis and was diagnosed as having uterine dehiscence with peritonitis.Uterine conserving surgery by freshening up of the margins with resuturing of uterine dehiscence was done.Patient developed a burst abdomen which was again managed by a conservative re-exploratory laparotomy.Patient was discharged in a stable condition.