title: Uterine perforation during second-trimester abortion by cervical dilation and instrumental extraction: a review of 15 cases.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, San Francisco General Hospital, University of California.
authors.forename: P D
authors.initials: PD
authors.lastname: Darney
authors.forename: E
authors.initials: E
authors.lastname: Atkinson
authors.forename: K
authors.initials: K
authors.lastname: Hirabayashi
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects* / Q000379:methods; D000293:Adolescent; D000328:Adult; D004106:Dilatation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007422:Intestines / Q000293:injuries; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014595:Uterine Perforation / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D014597:Uterine Rupture / Q000209:etiology*; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects