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. 1988 Mar;14(1):55-9.
doi: 10.1111/j.1447-0756.1988.tb00073.x.

Laparoscopy as a diagnostic and therapeutic technique in uterine perforations during first trimester abortions

P Kumar, P Rao

Laparoscopy as a diagnostic and therapeutic technique in uterine perforations during first trimester abortions

P Kumar et al. Asia Oceania J Obstet Gynaecol. 1988 Mar.

Abstract

PIP: Uterine perforation during 1st trimester abortion may be diagnosed and treated by means of laparoscopy. In 2967 1st trimester abortions, done by vacuum aspiration between 1980 and 1984, there were 12 instances of uterine perforation, 7 of which were done by dilators. In 8 of the 12 cases the site of perforation was at the fundus; 2 were in the anterior wall, and 2 were lateral. Uterine perforation does not seem to be a complication of undiagnosed flexion of the uterus, since the site of the perforation in that case would be in the anterior or posterior wall, rather than in the fundus. Fundal perforation is probably due to the fact that the uterus is corrected to midline by cervical traction during the abortion procedure. In the 8 fundal perforations the position of the uterus was retroverted in 2, anteverted in 2, midposition in 2, and anteverted anteflexed in 2. Retroversion does not therefore appear to be a contributory factor to uterine perforation. Immediate laparotomy was done in 2 of the cases because they had bowel involvement. Of the other 10 cases only 1 required laparotomy; in the others the abortion was completed vaginally with laparoscopic guidance. To prevent uterine perforation a proper pelvic examination should be done before medical termination of pregnancy.

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