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Case 26 - A 30-Year-Old G1 Woman with Suspected Uterine Perforation during Suction Dilation and Curettage

Published online by Cambridge University Press:  19 November 2021

Todd R. Jenkins
Affiliation:
University of Alabama, Birmingham
Lisa Keder
Affiliation:
Ohio State University School of Medicine, Columbus
Abimola Famuyide
Affiliation:
Mayo Clinic, Rochester
Kimberly S. Gecsi
Affiliation:
Medical College of Wisconsin
David Chelmow
Affiliation:
Virginia Commonwealth University School of Medicine
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Summary

A 30-year-old female, gravida1, para 0, presents to the office for a suction dilation and curettage (D&C) for management of a six-week missed abortion. Transvaginal ultrasound diagnosed the missed abortion one week ago and it was reconfirmed three days ago. She is taking ibuprofen 400 mg PO q 4 hours PRN and took diazepam 5 mg PO × 1 before arriving. She has no past medical or surgical history and no known drug allergies. On bimanual examination, a small, retroflexed uterus is noted. The cervix is stenotic, but dilation was able to be performed. Near the end of the procedure, the suction cannula passes without resistance deeper than expected. The patient describes a sudden increase in her pain. The procedure is stopped.

Type
Chapter
Information
Surgical Gynecology
A Case-Based Approach
, pp. 74 - 77
Publisher: Cambridge University Press
Print publication year: 2021

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References

Allen, RH, Goldberg, AB. Cervical dilation before first trimester surgical abortion: Society of Family Planning Clinical Guideline. Contraception 2016; 93: 277–91.CrossRefGoogle Scholar
Tristan, AB, Gilliam, M. First trimester surgical abortion. Clin Obstet Gynecol 2009; 52: 151–9.CrossRefGoogle ScholarPubMed
Augustin, G, Majerovic, M, Luetic, T. Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review. Arch Gynecol Obstet 2013; 288: 311–23.Google Scholar
Hakim-Elahi, E, Burnhill, MS. Complications of first-trimester abortion: a report of 170,000 cases. Obstet Gynecol 1990; 76: 129–35.Google Scholar
Lichtenberg, ES, Grimes, DA. Surgical complications: prevention and management. In: Paul, M, Lichtenburg, ES, Borgatta, L, et al., eds., Management of Unintended and Abnormal Pregnancy, 2nd ed. Chichester: John Wiley & Sons Ltd. 2009; 224–51.Google Scholar
Amarin, ZO, Badria, LF. A survey of uterine perforation following dilation and curettage or evacuation of retained products of conception. Arch Gynecol Obstet 2005; 271: 203–6.CrossRefGoogle ScholarPubMed
Kaali, SG, Szigetvari, IA, Bartfai, GS. The frequency and management of uterine perforations during first-trimester abortions. Am J Obstet Gynecol 1989; 161: 406–8.Google Scholar
Freiman, SM, Wulff, GJ. Management of uterine perforation following elective abortion. Obstet Gynecol 1977; 50: 647–50.Google ScholarPubMed
Chaikof, M, Lazer, T, Gat, I, et al. Lower complication rates with office-based D&C under ultrasound guidance for missed abortion. Minerva Ginecol 2017; 69: 23–8.Google ScholarPubMed
Kapp, N, Whyte, P, Tang, J, Jackson, E, Brahmi, D. A review of evidence for safe abortion care. Contraception 2013; 88: 350-363.CrossRefGoogle ScholarPubMed

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