Uterine inversion after controlled cord traction during caesarean section: a case report.

INTRODUCTION: Inversion of the uterus during caesarean section is a rare but life-threatening complication of the procedure that requires immediate treatment, which is reversion and awareness due to the very serious adverse effects that it may have. MATERIALS AND METHODS: The authors present a case of a 34-year-old para 1 woman of Greek ethnicity who underwent a scheduled caesarean section at 39 weeks of gestation. During the procedure, a uterine inversion occurred as a controlled cord traction was applied in order to achieve placental detachment, after the delivery of the baby. It was managed by immediate manual uterine reversion, which was performed after exteriorization of the uterus. There were no adverse effects. CONCLUSION: Uterine inversion during caesarean section is a serious complication, but fortunately very rare. However, the obstetrician should be aware that the complication should be quickly identified and act without hesitation because it is critical for the well being of the patient.

Abdominal wall endometriosis after a caesarian section--an interesting case report.

BACKGROUND: Endometriotic foci can be rarely found on the surgical incision following caesarean delivery and on perineotomy site following vaginal delivery. CASE: A 33-year-old woman with a history of caesarian section five years prior was admitted to the present clinic due to right groin pain with increasing intensity during menstruation. Ultrasound revealed an endometrioma-like subcutaneous mass directly under the right edge of the Pfannenstiel scar. The mass (3.5 x 2.4 x 2 cm) was removed en bloc with ultrascissor. CONCLUSION: The prevailing argument supports that it is a complication caused by the iatrogenic dispersal of endometrial material. Symptoms onset vary from one to five years postoperatively and mainly include pain and enlargement of the mass during menstruation. Diagnosis may be demanding due to the atypical presentation of the disease. Symptoms exacerbate during menstruation in only 20% of all cases. Abdominal ultrasound is extremely useful for diagnosis. The treatment of choice is surgical excision.