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Case Reports
. 2025 Jan 9;17(1):e77183.
doi: 10.7759/cureus.77183. eCollection 2025 Jan.

Successful Management of Complications Due to a Cesarean Section in a Patient With a Complex Obstetric History: A Case Report and Review of Preventive Strategies

Esha Parikh  1 , Samira Kanetkar  1 , Reena Sheth  1 , Renee Alexis  2
Affiliations
Case Reports

Successful Management of Complications Due to a Cesarean Section in a Patient With a Complex Obstetric History: A Case Report and Review of Preventive Strategies

Esha Parikh et al. Cureus. .

Abstract

A multiparous 37-year-old female patient (G7P3A4) with a complex obstetric history consisting of a myomectomy for uterine fibroids and a previous cesarean section (C-section) resulted in complicated intra- and postpartum events. The incidental cystotomy during the C-section was managed conservatively by catheterization. Postoperatively the patient suffered from postpartum menorrhagia and an enlarged uterus and was managed with an explorative laparotomy concluding with extensive lysis of adhesions and total abdominal hysterectomy and bilateral salpingectomy. The patient did well postoperatively and was discharged after 48 hours. She returned for an outpatient follow-up one week later and was reassured that her pain would improve within six to eight weeks. This case study details the complications and aftermath of intense intra-abdominal adhesions and calls for a better understanding of the management of adhesions for abdominal procedures.

Keywords: abdominal hysterectomy; complicated cesarean; intra-abdominal adhesions; multigravida; severe dysmenorrhea; uterine fibroids in pregnancy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Retrograde cystogram five weeks after the cesarean section
The red arrow shows an intact bladder.
Figure 2
Figure 2. A CT scan of the abdomen and pelvis eight weeks before total abdominal hysterectomy
The red arrow shows the uterine fibroid.
See this image and copyright information in PMC

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