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Abstract
Introduction :
Necrotizing fasciitis (NF) during pregnancy is rare but potentially fatal, with high rates of morbidity and perinatal mortality.
Observation :
A 20-year-old pauciparous woman presented to our department with metrorrhagia, abdominal distension and pain associated with an abscess of the thigh and right leg in a febrile context, at 39 weeks of pregnancy. Clinical and paraclinical examination and exploratory laparotomy led to a diagnosis of uterine rupture that had been developing for seven days, complicated by necrotizing fasciitis and fetal death. The patient received multidisciplinary care including a total hysterectomy, meticulous surgical debridement of necrotic tissue in the pelvic region, and a maternal resuscitation protocol. She was then transferred to a specialized surgical unit for further care, where her clinical and biological progress was favorable. However, the patient was discharged from hospital against medical advice due to lack of financial resources on day 30 of hospitalization.
Conclusion :
This observation shows that uterine rupture can be an overlooked cause of NF, the diagnosis and management of which can be difficult in resource-limited settings.
References
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