JOTHI DORAISWAMY and ISAAC BABARINSA describe the use of intra-operative suprapubic ultrasound scanning in congenital or acquired abnormalities of the womb, persistent bleeding after previous uterine evacuation and unexpected deviation from normal.
Evacuation of the uterus is a common gynaecological ambulatory or inpatient surgical procedure worldwide. Although most procedures can be performed safely, occasionally the procedure will require the use of adjunctive techniques to reduce the probability of the creation of a ‘false passage’, perforation of the uterus or the need for a subsequent repeat.
Evacuation of the uterus during a normal or complicated early pregnancy, endometrial sampling with the curette or endometrial instrumentation of the most simple type, can be complicated by perforation. This may occasionally involve adjacent viscera, incomplete procedure or the creation of a ‘false passage’. Uterine perforation is an uncommon (five-in1000) but potentially serious complication of uterine manipulation1 and it does carry significant risk of future morbidity with a risk of uterine rupture in pregnancy and labour and lower thresholds for Caesarean section.
Factors that increase the risk of uterine perforation include uterine anomalies, infection, recent pregnancy, previous uterine surgery and post menopause.
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