Postpartum Necrotizing Myositis With Endometrial Prolapse.

Abstract

BACKGROUND:

Postpartum necrotizing myositis is a rare condition, typically presenting as a complication after uterine artery embolization or uterine compression suturing. Uterine ischemia can cause endometrial necrosis and even myometrial necrosis, which can lead to systemic infection. If a systemic infection is not promptly and actively treated, it may pose significant risk.

CASE:

A 35-year-old patient who had undergone bilateral uterine artery ligation, modified B-Lynch suture, and multiple compression sutures due to refractory postpartum hemorrhage frequently presented to clinic after postpartum discharge due to persistent fever and vaginal discharge. A bag-like prolapse from the vagina measuring 10×5 cm, accompanied by purulent discharge, was noted 78 days postsurgery. Subsequent pelvic magnetic resonance imaging revealed a uterine basal abscess and postpartum necrotizing myositis; an emergency laparoscopic supracervical hysterectomy was performed, with postoperative pathology confirming the diagnosis. After the patient's discharge, she was readmitted for inpatient treatment of a pelvic abscess.

CONCLUSIONS:

Although rare, postpartum necrotizing myositis should be considered in postpartum patients presenting with fever, abdominal pain, severe infection symptoms, and abnormal vaginal discharge. Culture and sensitivity testing are recommended to direct appropriate antibiotic therapy.

• Authors: Rongyao Li, Zheng Fang, Qingqing Zhou, Jing Fu, Ran Meng, Qiaoyun Cai, Yingli Shen, Cheng Peng
• Journal: Obstetrics and gynecology (Obstet Gynecol) Vol. 143 Issue 5 Pg. e136-e139 (May 01 2024) ISSN: 1873-233X [Electronic] United States
• PMID: 38513235 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2024 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

Topics

• Pregnancy
• Female
• Humans
• Adult
• Abscess
• Postpartum Hemorrhage (therapy)
• Postpartum Period
• Prolapse
• Vaginal Discharge
• Necrosis (complications)
• Myositis (diagnosis, therapy, complications)