title: Uterine perforation during curettage: perforation rates and postperforation management.
abstract: Over a period of eight years, 13,344 consecutive patients underwent curettage in our hospital for various indications. Uterine perforation occurred in 22 (0.16%) of them. An additional seven patients were admitted with existing uterine perforation. The most common site of perforation was the uterine fundus and the instrument most often involved was a sharp curette. The perforation rates in curettage performed for postpartum hemorrhage and intrauterine adhesions were relatively high (5.1 and 1.8%, respectively); the rates in those for elective abortion and postmenopausal bleeding were intermediate (0.4 and 0.2%, respectively); and in those performed for other indications, the rate was very low (less than or equal to 0.06%). After uterine perforation occurred 15 patients (51.7%) were managed by observation only and the course was uneventful. In 10 patients (34.5%), exploratory laparotomy was performed; in three of them, no active bleeding organ injury was found. Judicious use of laparoscopy after uterine perforation allows proper selection of patients for further surgery.
mesh_terms: D003475:Curettage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D011247:Pregnancy; D014595:Uterine Perforation / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D014597:Uterine Rupture / Q000209:etiology*; D014599:Uterus / Q000601:surgery*