Asian Journal of Research in Surgery

Hysteroscopic Retrieval of Numerous Retained Fetal Bones Six Years Post Mid Trimester Abortion in a Patient with Secondary Infertility and Severe Dysmenorrhoea: A Case Report

Ayodeji Kayode Adefemi *

Lagos State University Teaching Hospital, Ikeja, Nigeria.

Chidinma Magnus Nwogu

Kingswill Advanced Specialist Hospital, Lagos, Nigeria.

Aloy Okechukwu Ugwu

68 Nigerian Army Reference Hospital, Yaba, Lagos, Nigeria.

Adebayo Williams Awoniyi

Lagos University Teaching Hospital, Idi-Araba, Nigeria.

*Author to whom correspondence should be addressed.

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Abstract

This case report highlights the significance of prolonged retention of multiple fetal bones six years following termination of pregnancy. Prolonged retention of fetal bone or bone fragments is an established cause of secondary infertility from recurrent endometritis and subsequent Asherman’s syndrome or bilateral tubal blockage. It is usually encountered following unsafe abortion in second trimester (mid trimester abortions). Transvaginal sonography is the initial screening imaging modality for evaluating the uterus of women in gynaecological outpatient clinic while a diagnostic or operative hysteroscopy is the gold standard in treating a woman with retained fetal bone.

We present a 33-year-old nullipara with a six-year history of severe dysmenorrhea following termination of pregnancy. On further evaluation she was found to have numerous retained fetal bone particles in her endometrial cavity which were retrieved via the use of hysteroscopy. She did well clinically and currently have painless menstruation.

Keywords: Chronic pelvic pain, hysteroscopy, mid trimester abortion, retained fetal bone, secondary infertility

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