The perforated uterus. (16th October 2013)

• Record Type: Journal Article
• Authors: Shakir, Fevzi; Diab, Yasser
• Is Part Of: Obstetrician & gynaecologist. Volume 15:Number 4(2013)
• Page Start: 256
• Page End: 261
• Publication Date: 2013-10-16
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/tog.12056
• Languages: English
• ISSNs: 1467-2561

Abstract

<abstract abstract-type="main" id="tog12056-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="tog12056-sec-0001" sec-type="section"> <title>Key content</title> <p> <list id="tog12056-list-0001" list-type="bullet"> <list-item> <p>Uterine perforation is an uncommon but potentially serious complication of uterine manipulation, evacuation of retained products of conception or termination of pregnancy (TOP), hysteroscopic procedures and during coil insertion.</p> </list-item> <list-item> <p>Factors that increase the risk of uterine perforation include uterine anomalies, infection, recent pregnancy and postmenopause. TOP is the most common procedure associated with uterine perforation.</p> </list-item> <list-item> <p>Prevention of uterine perforation is favoured, although if it occurs, initial recognition together with immediate and ongoing management is key to reducing morbidity, mortality and long‐term consequences.</p> </list-item> <list-item> <p>It is important that surgeons performing surgical TOP are adequately trained. The experience of the surgeon results not only in fewer perforations but also in the early recognition of uterine injury.</p> </list-item> <list-item> <p>Uterine perforation is a complication that is well recognised by all gynaecologists, although subsequent assessment and management needs to be standardised.</p> </list-item> </list> </p> </sec> <sec id="tog12056-sec-0002" sec-type="section"> <title>Learning objectives</title> <p> <list id="tog12056-list-0002" list-type="bullet"> <list-item> <p>To be aware of the incidence of uterine perforation and the potential serious complications that can result.</p> </list-item> <list-item> <p>To identify the risk factors of uterine perforation, the mechanism of injury and how to potentially prevent it from occurring.</p> </list-item> <list-item> <p>To increase awareness of this complication and to propose a standardised management protocol if a uterine perforation occurs, together with risk management issues.</p> </list-item> </list> </p> </sec> <sec id="tog12056-sec-0003" sec-type="section"> <title>Ethical issues</title> <p> <list id="tog12056-list-0003" list-type="bullet"> <list-item> <p>Are women at increased risk of uterine perforation counselled adequately about the complications and consequences?</p> </list-item> <list-item> <p>Are women at increased risk given the full range of alternative treatment options?</p> </list-item> </list> </p> </sec> </abstract>