Rupture of posterior cul-de-sac: a rare complication following cesarean in low station of fetal head: a case report

Document Type : Case report

Authors

1 Assistant professor, Department of Obstetrics and Gynecology, Women's Health Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Anesthesiologist, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Fetal extraction difficulty during cesarean delivery occurs in 1 to 2% of cases that one of the causes is impacted fetal head in delivery canal which is associated with many fetal and maternal complications. In this report, we introduce a 26 years old woman who is complicated with rupture of posterior cul-de-sac during cesarean in low station of fetal head which is a rare complication.
Case presentation: A 26 years old woman with first pregnancy at term presented to the hospital with labor pain in active phase of labor. In the second stage of labor, she was transferred to operative room for cesarean section due to prolonged deceleration of fetal heart rate (FHR). Because of impacted fetal head in delivery canal, the assistant placed her hand into the vagina to push the fetal head up into the uterus in order to surgeon can extract the fetus (abdominovaginal method). But this method was unsuccessful and fetus was extracted with reverse breech extraction method. Then we noticed rupture of posterior cul-de-sac in length 4-cm and it was repaired and the abdomen was closed. Patient was discharged after 72 hours with good condition and no signs and symptoms of infection.
Conclusion: Damage to the adjacent tissues and ligaments of the uterus is mentioned as a complication of performing cesarean in low station that the surgeon should pay special attention to these complications when repairing the caesarean site in cases of low station.

Keywords

References

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