Uterine perforation during intrauterine procedures and its management
Language English Country Czech Republic Media print
Document type Journal Article, Systematic Review
PubMed
36055792
DOI
10.48095/cccg2022295
PII: 131668
Knihovny.cz E-resources
- Keywords
- dilatation and curettage, doppler ultrasound of uterine artery, endometrial cancer, hysteroscopy, injury, intrauterine device, pregnancy termination, risk factors, uterine perforation,
- MeSH
- Humans MeSH
- Uterine Perforation * etiology surgery MeSH
- Pregnancy MeSH
- Uterus surgery MeSH
- Check Tag
- Humans MeSH
- Pregnancy MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Systematic Review MeSH
OBJECTIVE: Uterine perforation is a potential, not rare complication of all intrauterine procedures and may be associated with injury of surrounding organs and structures. The incidence, risk factors, possible prevention, dia-gnosis, management and impact on future reproduction is reviewed here. METHODS: Systematic review of available sources on the topic was carried out using the PubMed database and textbooks of Czech authors. CONCLUSION: Some risk factors that make access to the uterine cavity difficult may be prevented, however, others remain unpreventable. For patients in whom the perforation occurred during sondage, dilatation or insertion of blunt and cold instrument, without significant bleeding and who are hemodynamically stable, observation is recommended rather than immediate abdominal exploration. The exception are young women planning pregnancy in whom endoscopic suture is indicated. Abdominal exploration is required in patients who have been injured by electrosurgical or sharp device, laser, vacuum curette, who are hemodynamically unstable or show signs of severe bleeding or visceral injury.
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