Clinical case of severe postpartum endometritis: metroplasty as a method of preserving reproductive function

Postpartum endometritis is a pressing issue in modern obstetrics. Risk factors for the development of postpartum endometritis include uterine scarring, premature rupture of membranes, surgical correction of cervical insufficiency, and chorioamnionitis. Rational antibacterial therapy is recognized as the primary treatment for women with postpartum endometritis. However, if the condition becomes generalized, it can lead to indications for hysterectomy and the development of sepsis, which is a leading cause of maternal mortality. This case report concerns a multiparous patient with a uterine scar whose second pregnancy resulted in an emergency abdominal delivery at 26 weeks of gestation with an unfavorable perinatal outcome, as well as the development of severe endometritis one month after delivery. Organ-preserving surgical treatment in the gynecology department of the V.I. Krasnopolsky Moscow Regional Research Institute of Obstetrics and Gynecology and rational antibacterial therapy enabled the patient to preserve reproductive function and prolong her subsequent pregnancy until a favorable perinatal outcome.