Pyometra in the postpartum: a forgotten complication

Rana A. Choudhary, Kedar N. Ganla, Kavita N. Desai, Priyanka H. Vora


We report a case of 37 years old women who conceived after in vitro fertilization (IVF). Her antenatal course was uneventful. On delivery there was placenta acreta. She later presented in the postpartum period with pyometra. She was managed with conservative treatment. We believe that the placental bed sutures and the sloughing placenta could have led to sterile pyometra in this patient. This rare but important complication need to be kept in mind specially in high risk women with thin endometrium, h/o IVF, cervical encerclage, and placenta acreta.


Cervical encerclage, Placenta accreta, Pyometra, Thin endometrium

Full Text:



Toglia MR, Fagan MJ. Pyometra complicating a LeFort colpocleisis. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20(3):361-2.

Schlumbrecht M, Balgobin S. Pyometra after thermal endometrial ablation. Obstet Gynecol. 2007;110(2 Pt 2):538-40.

Yildizhan B, Uyar E. Spontaneous perforation of pyometra. Infect Dis Obstet Gynecol. 2006:267-86.

Hofmann GE, Warikoo P. Ultrasound detection of pyometra at the time of embryo transfer after ovum retrieval for IVF. Fertil Steril. 2003;80(3):637-8.

Yildizhan B, Uyar E. Spontaneous perforation of pyometra. Infect Dis Obstet Gynecol. 2006;2006:26786.

Chan LY, Lau TK. Pyometra. What is its clinical significance? J Reprod Med. 2001;46(11):952-6.

Barry C. Pyometra in childhood. Obstet Gynecol. 2015;125(5):1035-8.

Rebecca Allen. Uses of Methergin in Obstetrics and Gynecology. Rev Obstet Gynecol. 2017;2(3):159-168.

Chan LY, Yu VS. Spontaneous uterine perforation of pyometra. A report of 3 cases. J Reprod Med. 2000;45(10):857-60.

Ou YC, Lan KC. Clinical characteristics of perforated pyometra and impending perforation: specific issues in gynecological emergency. J Obstet Gynaecol Res. 2010;36(3):661-6.

Sirha R, Miskin A, Abdelmagied A. Postnatal pyomyoma: a diagnostic dilemma. Case Reports 2013;bcr2013201137.

Shayya RF. Pyometra after Le Fort colpocleisis resolved with interventional radiology drainage. Obstet Gynecol. 2009;113(2 Pt 2):566-8.