[Uterine necrosis upon acute caesarean section in a homozygous factor VLeiden patient]

Peripartum hysterectomy is a rare but life-saving procedure. Haemorrhage, atony, placenta accreta/praevia or uterus rupture are the most common reasons for hysterectomy. This case report presents a 35-year-old woman, gravida 2, para 1, with total necrosis of the uterus and ovaries bilaterally after an acute caesarean section. Pathological examination showed thrombosis and haemorrhagic infarction. Besides pre-eclampsia the patient had no co-morbidity. Later analysis found homozygosity for factor VLeiden mutation. Hysterectomy was life-saving but the patient developed acute renal failure with late recovery.