Sepsis after Bartholin's duct abscess marsupialization in a gravida

BACKGROUND: Little information exists regarding sepsis following marsupialization of a Bartholin's duct abscess. We report a gravida who became septic after marsupialization. CASE: A 30-year-old primigravida at 32 weeks' gestation underwent marsupialization of a Bartholin's gland abscess. Postoperatively, she developed fever with maternal and fetal tachycardia. She was admitted to the hospital and started on broadspectrum antibiotics. Her temperature increased to 39°C, and she became hypotensive. Blood work demonstrated evidence of disseminated intravascular coagulopathy. The patient was stabilized with aggressive fluid resuscitation, antibiotics, transfusion of blood products and oxygen therapy. Within 24 hours, the fever and coagulopathy resolved. She was discharged on postoperative day 5 and gave birth without complications at 38 weeks' gestation. CONCLUSION: Pregnant women undergoing marsupialization of a Bartholin's gland abscess should be considered at high risk and managed accordingly.