Operative hysteroscopy-assisted pregnancy termination after failed surgical abortion in missed abortion of woman with complete septate uterus
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First trimester surgical abortion is an effective and safe procedure. Although its failure is uncommon, congenitaluterine anomaly may be considered as one of the etiologic factors in such cases. Here, we report a rare case ofsurgical abortion failure that was successfully managed by operative hysteroscopy-assisted dilatation and evacuation(D&E) under ultrasound guidance in a woman with complete uterine septum. The patient was referred to SeveranceHospital after two consecutive surgical abortion failures even under ultrasound guidance. A missed abortion in a leftsidedhemicavity of septate uterus was noted on ultrasonography. Ultrasound-guided D&E was unsuccessful becausethe curette could not reach the uterine cavity with the gestational sac. Operative hysteroscopy revealed insufficientcommunication with the left-sided cavity just above the cervical internal os of the uterine septum. After widening thecommunication, ultrasound-guided D&E was successfully performed.
Abstract
First trimester surgical abortion is an effective and safe procedure. Although its failure is uncommon, congenitaluterine anomaly may be considered as one of the etiologic factors in such cases. Here, we report a rare case ofsurgical abortion failure that was successfully managed by operative hysteroscopy-assisted dilatation and evacuation(D&E) under ultrasound guidance in a woman with complete uterine septum. The patient was referred to SeveranceHospital after two consecutive surgical abortion failures even under ultrasound guidance. A missed abortion in a leftsidedhemicavity of septate uterus was noted on ultrasonography. Ultrasound-guided D&E was unsuccessful becausethe curette could not reach the uterine cavity with the gestational sac. Operative hysteroscopy revealed insufficientcommunication with the left-sided cavity just above the cervical internal os of the uterine septum. After widening thecommunication, ultrasound-guided D&E was successfully performed.
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