The perforated uterus
Article first published online: 16 OCT 2013
© 2013 Royal College of Obstetricians and Gynaecologists
The Obstetrician & Gynaecologist
Volume 15, Issue 4, pages 256–261, October 2013
How to Cite
The perforated uterus. The Obstetrician & Gynaecologist 2013;15:256–61., .
- Issue published online: 16 OCT 2013
- Article first published online: 16 OCT 2013
- Manuscript Accepted: 15 JUN 2013
- Manuscript Revised: 13 JAN 2013
- Manuscript Received: 23 JUL 2012
- risk factors;
- risk management points;
- uterine perforation
- 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.
- 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.
- 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.
- 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.
- Uterine perforation is a complication that is well recognised by all gynaecologists, although subsequent assessment and management needs to be standardised.
- To be aware of the incidence of uterine perforation and the potential serious complications that can result.
- To identify the risk factors of uterine perforation, the mechanism of injury and how to potentially prevent it from occurring.
- To increase awareness of this complication and to propose a standardised management protocol if a uterine perforation occurs, together with risk management issues.
- Are women at increased risk of uterine perforation counselled adequately about the complications and consequences?
- Are women at increased risk given the full range of alternative treatment options?