title: Medicolegal aspects of an unusual uterine perforation with multiload-Cu 375R.
abstract: Perforation of the uterus is one of the most serious complications associated with insertion of intrauterine contraceptive devices (IUD). According to recent studies, this lesion occurs in 0.87 per 1000 cases, but statistics generally fluctuate between 0.05 and 13 per 1000 insertions. "Primary" perforations occur at the time of IUD insertion, and "secondary," or delayed, perforations are usually assumed to be caused by reactive uterine contractions. We report an unusual case of uterine perforation, which occurred 9 days after the insertion of a Multiload-Cu 375 IUD. The criteria for differential diagnosis between primary and secondary complications are discussed, particularly from the perspective of medical malpractice cases.
authors.affiliation: Institute of Legal Medicine, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Grimaldi
authors.forename: Fabio
authors.initials: F
authors.lastname: De Giorgio
authors.forename: Pia
authors.initials: P
authors.lastname: Andreotta
authors.forename: M Clara
authors.initials: MC
authors.lastname: D'Alessio
authors.forename: Carlo
authors.initials: C
authors.lastname: Piscicelli
authors.forename: Vincenzo L
authors.initials: VL
authors.lastname: Pascali
mesh_terms: D020878:Device Removal; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging*; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D010535:Laparoscopy; D008875:Middle Aged; D013997:Time Factors; D014463:Ultrasonography; D014595:Uterine Perforation / Q000209:etiology*; D014599:Uterus / Q000000981:diagnostic imaging