The frequency and management of uterine perforations during first-trimester abortions

Kaali, Steven G.; Szigetvári, Iván; Bártfai, G

doi:10.1016/0002-9378(89)90532-2

Cited by 91 publications

(54 citation statements)

References 7 publications

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“…Major complications requiring hospitalization have ten times less incidence (0.071%) and include incomplete abortion, sepsis, uterine perforation, vaginal bleeding, inability to complete abortion, and combined (heterotopic) pregnancy. Uterine perforation during abortion is rare, with incidence of 0.05 -0.4% [12][13][14][15][16][17] but up to 3.6% in undeveloped countries [18].…”

Section: Incidence and Trimester Distributionmentioning

confidence: 99%

Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Augustin

Majerović

Luetić

2013

Arch Gynecol Obstet

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Section: Incidence and Trimester Distributionmentioning

confidence: 99%

Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Augustin

Majerović

Luetić

2013

Arch Gynecol Obstet

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“…Conservative protocols for patients with known or suspected low-risk perforations have been advocated by a variety of authors. 4 However, if considerable intraabdominal damage has been caused by instruments, especially suction and sharp curettes, passed through a uterine defect into the peritoneal cavity, as in the present case, laparotomy to examine the abdominal contents is often the safest course of action.…”

Section: Dear Editormentioning

confidence: 75%

“…3 However, perforation of the myometrium may be unrecognized and bladder rupture following such a complication may be underreported. Kaali et al 4 found that only two of 14 uterine wall perforations were recognized in a series of 706 patients undergoing concurrent firsttrimester vacuum abortion and laparoscopic sterilization. Suspicion of perforation is raised when instruments pass farther than expected, often without discernible resistance; when bleeding is excessive, as in the case under discussion; or when contact with the gritty surface of the endometrium is lost during aspiration or curettage.…”

Section: Dear Editormentioning

confidence: 99%

Bladder Rupture Following Surgical Mid-Trimester Abortion

Pallavee

Samal

Thulasi

et al. 2013

Nepal j. obstet. gynaecol.

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A 25 years 2nd gravida with previous normal vaginal delivery was admitted with complaints of excessive vaginal bleeding following surgical termination of pregnancy at 16 weeks of gestation at a private hospital. Clinical examination revealed mild abdominal distension and a bulky uterus with moderate amount of bleeding per vaginum.Emergency ultrasound showed bulky uterus wth an empty cavity and free fluid in abdomen and pelvis. Abdominal X-Ray (erect view) didn't reveal any bowel perforation. Perurethral catheterisation showed frank hematuria. Patient was prepared for emergency laparotomy with a provisional diagnosis of uterine perforation with bladder injury.Per operatively, hemoperitoneum of 1500 ml and uterus enlarged to 14 weeks size with a vertical rent of 6 cm in the anterior wall. Bladder examination revealed 10 cm full thickness tear at the roof and 5 cm partial thickness tear in the anterior wall. (Fig. 1) Bowel exploration revealed no injury. Both the uterine and bladder rents were repaired. Suprapubic cystotomy and per urethral catheterization were done. Check cystogram on 14 th post-operative day revealed right vesico-ureteric reflux with no bladder leak. (Fig. 2 Bladder rupture following perforation of the uterus in association with elective mid-trimester abortion is an uncommon, but potentially serious complication. Such lacerations not only increase the immediate post-abortal morbidity but may also adversely influence future reproductive performance. Uterine perforation rates are highest in teaching settings and in cases of advanced parity and gestation. 1The exact incidence of such complication is not known. Early result of follow up study by Mackay et al showed increased risk of perforation of the myometrium with general anesthesia was reversed.2 In a large first trimester NJOG 2012 Jan-June; 7(3): 64-65 letter to editor

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“…14 On the other side, uterine perforation after D&C is also rare (1.98%) 15 and many uterine perforations were unrecognized or asymptomatic 16 and just treated conservatively. However, serious complications of perforation can happen.…”

Section: Discussionmentioning

confidence: 99%

An incidental finding of heterotopic pregnancy in a patient presented with acute abdomen post D&C of unwanted pregnancy

Abed¹,

Yassin²,

Salih³

et al. 2016

JYP

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Spontaneous heterotopic pregnancy is a rare condition. There is the simultaneous presence of intrauterine and extrauterine pregnancies. Such condition can be a life-threatening. The diagnosis can also be easily missed especially in early pregnancy. We present this case of a 28-year old patient who was misdiagnosed as normal intrauterine pregnancy. She had illegal termination of unwanted 14-week pregnancy in a private hospital. The patient presented to us with acute abdomen two days after D&C. Following clinical examination, uterine perforation was suspected. Abdominal ultrasound showed a coexisting abdominal pregnancy in the right hypochondrium. his heterotopic pregnancy was undiagnosed at her initial presentation to the first hospital. Emergency laparotomy was done, uterine perforation was sutured and abdominal pregnancy was excised.

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The frequency and management of uterine perforations during first-trimester abortions

Cited by 91 publications

References 7 publications

Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review

Bladder Rupture Following Surgical Mid-Trimester Abortion

An incidental finding of heterotopic pregnancy in a patient presented with acute abdomen post D&C of unwanted pregnancy

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