Septic Abortion at 17 Weeks Gestation After Radical Trachelectomy and Transabdominal Cerclage: A Case Report

Abstract

Introduction Septic abortion can lead to severe maternal morbidity and mortality. The management of septic abortion can be complicated by a history of radical trachelectomy and transabdominal cerclage placement. Case Presentation A 33-year-old G1P0 at 17 weeks and 6 days gestation presented in severe septic shock after being diagnosed with previable rupture of membranes 6 days prior. Her history was notable for cervical adenocarcinoma status post radical trachelectomy and transabdominal cerclage placement. Due to uterine occlusion from the cerclage, she underwent emergent uterine evacuation via an abdominal approach. Conclusions The risks and benefits of expectant management of pre-viable rupture of membranes in patients with abdominal cerclage should be weighed very cautiously. Among women with abdominal cerclage for whom uterine evacuation is indicated, a transabdominal approach may be necessary.