Pelvic Abscess after Cesarean Section with Hayman Compression Suture in Maternal Syphilis and Uncontrolled Diabetes Mellitus
Introduction: Pelvic abscess is a low incident rate complication after cesarean section, otherwise it can cause re-operation and hysterectomy.
Case study: A Thai 22-year-old pregnancy was detected uncontrolled diabetic mellitus and late latent syphilis that treatment during pregnancy. At Gestational age 38+2 weeks presented with labor pain. Admit for augmentation and then cesarean section due to non-reassuring fetal heart rate pattern. After cesarean section, Hayman compression suture was done due to uterine atony. At Day 17th after delivery presented with pelvic pain and mass at left lower quadrant. CT scan whole abdomen revealed multiple pelvic abscess, the largest pocket abuts left-sided uterus, about 7.6×7.9×9.9 cm Patient was referred to tertiary care for per cutaneous drainage and antibiotics treatment. No organism in pus culture. Off drain 7 days after treatment.
Conclusion: There are multiple factors that causing infection after delivery. The main factor is maternal factor: uncontrolled diabetic and late latent syphilis. Operative factor are emergency cesarean section and compression suture. Therefore, should beware the complication in other case that cesarean section or compression suture operation.
Key words: pelvic abscess, cesarean section, syphilis, diabetes mellitus