UTERINE PERFORATION DURING CURETTAGE - PERFORATION RATES AND POST-PERFORATION MANAGEMENT

  • 1 January 1980
    • journal article
    • research article
    • Vol. 16  (12) , 821-824
Abstract
Over a period of 8 yr, 13,344 consecutive patients underwent curettage for various indications. Uterine perforation occurred in 22 (0.16%) of them. An additional 7 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 1.80%, 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 (.ltoreq. 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 3 of them, no active bleeding or internal organ injury was found. Judicious use of laparoscopy after uterine perforation allows proper selection of patients for further surgery.

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