Intramyometrial abscess complicating pregnancy. A report of two cases

Intramyometrial abscess in pregnancy is a rare event. Little information is available on the presentations and potential complications.

Two asymptomatic patients underwent complications with failed instrumental delivery in the second stage of labor. Intramyometrial abscesses were found during lower segment cesarean section. In the first case, incision and drainage was done, and the culture of the pus revealed multiple organisms, including Escherichia coli, group B Streptococcus and Klebsiella species. The patient was successfully treated with antibiotics, while the infant did not show any evidence of infection. In the second case, removal of the abscess was performed, and pathology showed evidence of chronic abscess, but the culture did not reveal any organisms. The patient was treated with prophylactic antibiotics. The infant was treated with antibiotics for clinical sepsis, but no organism was revealed.

Intramyometrial abscess complicating pregnancy can be asymptomatic. Obstructed labor can be a potential complication when the abscesses are located in the lower uterine segment. Antibiotics, together with incision and drainage or removal of the abscess, is the first choice for treatment.