Postcesarean Uterine Scar Dehiscence as Rare Cause of Puerperal Sepsis—A Case Series

Aim and background: In the last few decades, the rate of cesarean section is increasing, and thus its sequelae.Once considered the rarely seen complications are now more commonly being confronted; the incidence of uterine scar dehiscence is 0.06-3.8%after cesarean section.We are sharing our experience of managing 11 cases with postcesarean scar dehiscence presenting with puerperal sepsis.Methodology: This is a case series of 11 patients admitted in the obstetrics and gynecology department of a tertiary care hospital at southeastern region of Rajasthan over the duration of October 2022 to December 2023.Their presenting complaints, duration of onset, associated symptoms, treatment given during hospital stay, preoperative imaging findings, and procedure done were retrieved from clinical case records.Result: The age-group of women was 23-39 years with a mean of 33.4 years.The mean duration of cesarean section to admission at our hospital was 11.6 days.All patients had pain in abdomen and fever; abdominal distension was found in 10 of 11 patients.Vomiting, loose motions, difficulty in respiration, and purulent discharge per vaginum and from stitch line were the other complaints. Conclusion:The diagnosis of postcesarean uterine scar dehiscence as a cause of postpartum septicemia requires a high clinical suspicion with prompt recognition and evaluation.The use of imaging modality is always a bliss for early diagnosis.An early exploratory laparotomy in nonresponders is a game changer.Declining the rate of cesarean section definitely needs to be focused.Significance: As uterine dehiscence is considered as a rare cause of postpartum puerperal sepsis with limited literature available, this study is an effort to gather more information about these cases where a high clinical suspicion, knowledge, and awareness is essential to diagnose and treat at the earliest to avoid potentially catastrophic consequences like maternal near miss or mortality.