Reports of uterine rupture following surgical abortion are rare but may result in hemorrhage, sepsis, and even death. In this unique case, we describe how a transabdominal pelvic ultrasound performed at the bedside by an emergency department physician identified uterine rupture with retained products of conception and led to an emergent laparotomy and hysterectomy. This case illustrates how bedside ultrasound may be used in patients presenting with abdominopelvic pain following surgical abortion to shorten the time to definitive treatment and ultimately lower the morbidity and mortality associated with a diagnosis of life-threatening uterine rupture.
Ultrasound Uterine rupture Surgical abortion
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(Video) Longitudinal transabominal ultrasound image inferior to the uterus showing the fetal head in the peritoneal cavity. (AVI 1538 kb)
Lohr PA, Hayes JL, Gemzell-Danielsson K (2008) Surgical versus medical methods for second trimester induced abortion. Cochrane Database Syst Rev 23(1):CD0067124Google Scholar
Shulman SG, Bell CL, Hampf FE (2006) Uterine perforation and small bowel incarceration: sonographic and surgical findings. Emerg Radiol 13:43–45PubMedCrossRefGoogle Scholar
Peterson WF, Berry FN, Grace MR et al (1983) Second-trimester abortion by dilation and evacuation: an analysis of 11,747 cases. Obstet Gynecol 62:185–190PubMedGoogle Scholar
Grossman D, Blanchard K, Blumenthal P (2008) Complications of second trimester surgical and medical abortion. Reprod Health Matters 16(31 Supplement):173–182PubMedCrossRefGoogle Scholar
Crosfill FM, Hughes S (2006) Ultrasound scan appearance of perforated uterus after surgical evacuation of retained products of conception. J Obstet Gynaecol 26(3):278–279PubMedCrossRefGoogle Scholar
Sherer DM, Abulafia O, Anyaebunam AM (1998) Intra-and early postpartum ultrasonography: a review. Part II Obstet Gynecol Surv 53(3):181–190CrossRefGoogle Scholar
Dignac A, Novellas S, Fournol M et al (2008) Incarceration of the appendix complicating a uterine perforation following surgical abortion: CT aspects. Emerg Radiol 15:267–269PubMedCrossRefGoogle Scholar
Has R, Topuz S, Kalelioglu I, Tagrikulu T (2007) Imaging features of postpartum uterine rupture: a case report. Abdom Imaging 33:101–103CrossRefGoogle Scholar