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Case Report
Abnormal uterine bleeding six weeks after surgical termination of a second trimester pregnancy due to retained intra-uterine fetal bone
1 Radiology Registrar, Department of Medical Imaging, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, Australia
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Dr. Andrew Imrie
Department of Medical Imaging, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD 4102,
Australia
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Article ID: 100038Z08AI2018
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How to cite this article
Imrie A, Gill J. Abnormal uterine bleeding six weeks after surgical termination of a second trimester pregnancy due to retained intra-uterine fetal bone. J Case Rep Images Obstet Gynecol 2018;4:100038Z08AI2018.ABSTRACT
Introduction: Retained intra-uterine fetal bone is a known complication following surgical termination of a second trimester pregnancy. It is most commonly detected on investigation for acute pelvic pain or secondary infertility and can manifest up to 15 years after surgery. We describe a presentation of abnormal uterine bleeding only six weeks after surgical abortion of second trimester pregnancy. This is both a rare presentation of retained fetal bone and the earliest documented case following surgery.
Case Report: A healthy nulliparous 18-year-old female presented with painful per vaginal bleeding six weeks after surgical termination of a second trimester pregnancy. She had no past medical history or gynecological infection. A single linear echogenic endometrial focus was identified on trans-vaginal ultrasound. A diagnosis of retained intra-uterine fetal bone was confirmed after hysteroscopic resection. The patient was asymptomatic with regular menses at three month clinic follow-up.
Conclusion: Intra-uterine fetal bone should be considered in all females with echogenic intra-uterine material on trans-vaginal ultrasound following surgical abortion regardless of the interval between termination and symptom onset. It is a readily treatable cause of abnormal uterine bleeding with either hysteroscopic resection or dilatation and curettage with trans-abdominal ultrasound guidance.
Keywords: Curettage, Dilatation, Hysteroscopy, Pregnancy, Uterine hemorrhage
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Author Contributions
Andrew Imrie - Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Jas Gill - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this case report.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2018 Andrew Imrie et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
