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. 2024 Apr 30;9(2):V6-V9.
doi: 10.21980/J83643. eCollection 2024 Apr.

Vaginal Bleeding Due to Iatrogenic Uterine Perforation - A Case Report

John Costumbrado  1   2 , Leah Snyder  2 , Sassan Ghassemzadeh  1   2 , Daniel Ng  1   2
Affiliations

Vaginal Bleeding Due to Iatrogenic Uterine Perforation - A Case Report

John Costumbrado et al. J Educ Teach Emerg Med. .

Abstract

Uterine perforation is a rare but potentially life-threatening complication of gynecologic procedures. Serious complications include hemorrhage, infection, and injury to surrounding organ systems (eg, gastrointestinal, urological, vascular, etc.). Risk factors include advanced maternal age, prior gynecologic surgeries, and other anatomical features that impact the difficulty of accessing the uterine cavity. In this case report, we discuss a patient who presented to the emergency department (ED) with diffuse abdominal pain and vaginal bleeding that occurred after an elective dilation and curettage (D&C) for a termination of pregnancy. The diagnosis was suspected clinically and confirmed by imaging including ultrasound (US) and computed tomography (CT) of the abdomen and pelvis. The patient was managed operatively with a multidisciplinary approach including Gynecology, General Surgery, and Urology. The patient was stabilized and eventually discharged. Uterine perforation should be included in the differential for patients with a history of recent gynecologic instrumentation presenting with abdominal pain and vaginal bleeding. The stabilization of these patients requires aggressive volume resuscitation, controlling the source of bleeding, and emergent surgical consultation.

Topics: Gynecology, vaginal bleeding, ultrasound, computed tomography.

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References

    1. Kerns J, Steinauer J. Management of postabortion hemorrhage: release date November 2012 SFP Guideline #20131. Contraception. 2013 Mar;87(3):331–42. doi: 10.1016/j.contraception.2012.10.024. Epub 2012 Dec 4. - DOI - PubMed
    1. Aydeniz B, Gruber IV, Schauf B, Kurek R, Meyer A, Wallwiener D. A multicenter survey of complications associated with 21,676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol . 2002 Sep 10;104(2):160–4. doi: 10.1016/s0301-2115(02)00106-9. - DOI - PubMed
    1. Augustin G, Majerović M, Luetić T. Uterine perforation as a complication of surgical abortion causing small bowel obstruction: a review. Arch Gynecol Obstet. 2013;288(2):311–323. - PubMed
    1. Allen R, Goldberg A. Cervical dilation before first-trimester surgical abortion (<14 weeks’ gestation) SFP Guideline 20071. Contraception. 2007 Aug;76(2):139–56. doi: 10.1016/j.contraception.2007.05.001. Epub 2007 Jul 10. - DOI - PubMed
    1. Chauhan S, Martin J, Jr, Henrichs C, Morrison J, Magann E. Maternal and perinatal complications with uterine rupture in 142,075 patients who attempted vaginal birth after cesarean delivery: A review of the literature. Am J Obstet Gynecol . 2003 Aug;189(2):408–17. doi: 10.1067/s0002-9378(03)00675-6. - DOI - PubMed