Uterine perforation during second-trimester abortion by cervical dilation and instrumental extraction: a review of 15 cases

P D Darney, E Atkinson, K Hirabayashi
Obstetrics and Gynecology 1990, 75 (3): 441-4
Review of the records of 15 women who had uterine perforations at the time of second-trimester abortion by dilation and evacuation showed that unexpected pain (but not excessive bleeding) was the most prominent sign. All patients required laparotomy, but in no case was laparotomy necessary as an emergency procedure. Laparoscopy was not helpful. Two-thirds had bowel injuries and two required hysterectomy. Errors in estimating gestational duration, inadequate cervical dilation, and failure to use sonography characterized these complicated cases.

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