Preterm prelabour rupture of membranes and Vernix Caseosa Peritonitis: A case report

Abstract

Introduction: Vernix caseosa peritonitis (VCP) is a rare postpartum complication rarely recognized by clinicians despite an increased incidence of cesarean sections. Case report: A 23-year-old patient, who had not had any prior medical examination during pregnancy and with preterm premature rupture of the membranes (PPROM), gave birth by cesarean section. On the 4th day after the cesarean section, the patient developed fever and abdominal pain. Laboratory parameters showing inflammation were increased. Two bacteria were found in the swab of the lochia: Escherichia coli and Proteus mirabilis. After relaparotomy was performed inside the abdominal cavity, hemorrhagic-purulent contents and multiple cheesy fibrin deposits on the intestines were visible. After peritoneal lavage and triple antibiotic therapy prescribed in duration of seven days, the patient completely recovered. Histopathological analysis showed a mixture of inflammatory cells concentrated around non-nuclear cells with wrinkled edges, which primarily corresponded to the inflammatory-altered vernix. Conclusion: Early recognition of vernix caseosa peritonitis is very important because it can prevent the resection of the abdominal organs that are altered with inflammation.