Navigating the Complexities of Intracesarean IUCD: Sepsis and Postoperative Uterine Scar Dehiscence

Postoperative uterine scar dehiscence is a very rare but potentially serious complication following cesarean section, especially when associated with pelvic abscess and intra-uterine contraceptive device (IUCD)-related infection. We report the case of a 31-year-old multiparous woman with a history of two previous cesarean deliveries who was referred to us on the 14 th postoperative day of an emergency cesarean section with high-grade fever, chills, and foul-smelling vaginal discharge. She had gestational diabetes well-controlled with diet and was fitted with an intra-cesarean IUCD (Copper-T [CU-T] 380 A). Clinical examination and imaging were suggestive of abdominopelvic abscess with uterine scar dehiscence. Due to persistent fever spikes despite broad-spectrum antibiotics, exploratory laparotomy-drainage of abscess and scar revision surgery was performed. Staphylococcus aureus was isolated from the various sites and the antibiotic therapy was tailored accordingly. The patient responded well and was discharged on the postoperative day 7 following recovery. The case highlights the possibility of infection due to IUCD insertion carried out under suboptimal conditions.