title: Uterine Perforation During Dilation and Evacuation Prior to Fetal Extraction--Now What? A Case Report.
abstract: BACKGROUND
  Uterine perforation is an infrequent but serious complication of dilation and evacuation (O&E). The purpose of this case report is to describe management strategies once a uterine perforation is identified.
  
  
  METHODS
  A 15-year-old female at 15 weeks' gestation presented to a freestanding clinic for elective abortion. After serial cervical dilation, omentum was seen in the suction curette. The patient was transferred to a nearby hospital, she underwent an exploratory laparotomy. A 1.5-cm anterior uterine perforation was found. The uterus was evacuated under direct visualization prior to repair of the defect.
  
  
  CONCLUSIONS
  Uterine perforation during D&E often requires laparotomy to repair the defect and to evaluate for injury to adjacent organs. Evacuation can be completed transcervically under direct visualization or through the perforation site.
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Chen
authors.forename: Sloane
authors.initials: S
authors.lastname: York
authors.forename: Cassing
authors.initials: C
authors.lastname: Hammond
authors.forename: Lori
authors.initials: L
authors.lastname: Gawron
mesh_terms: D000028:Abortion, Induced / Q000009:adverse effects*; D000293:Adolescent; D005260:Female; D006801:Humans; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D014595:Uterine Perforation / Q000209:etiology* / Q000601:surgery*