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. 1973 Oct 15;117(4):522-6.
doi: 10.1016/0002-9378(73)90114-2.

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

N H Lauersen, S Birnbaum

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

N H Lauersen et al. Am J Obstet Gynecol. .

Abstract

PIP: During the period 10/71 to 1/73, laparoscopy was performed in 11 cases of instrumental uterine perforation during 1st trimester abortion at the New York Hospital-Cornell Medical Center. 7 of the 11 patients did not require laparotomy; the remaining 4 had laparotomy after preliminary laparoscopy (3 had uncontrollable bleeding or extensive uterine injury while 1 had bowel injury due to the laparoscope trocar). The reported incidence of uterine perforations during 1st trimester abortion ranges from 0.4/1000 abortions to 15/1000 abortions. The incidence is lowest when the abortion is performed using suction technique and local anesthesia. In this hospital, laparoscopy is performed as soon as the perforation occurs, using the same anesthesia if general anesthesia was used. Immediate laparotomy is performed in cases of extensive instrumentation after perforation or bowel injury. Abortion is completed either by suction or sharp curette; intra-abdominal bleeding can be controlled by cauterization under laparoscopic observation. This procedure eliminates the need for patient exploratory laparotomy and hence shortens hospital stay and minimizes medicolegal problems. The management of uterine perforation during 1st trimester abortion is also discussed.

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