Srofenyoh Ek, Addison M, Dortey B, Kuffour Pa
Department of Obstetrics and Gynaecology, Ridge Hospital, Accra, Ghana.
Ghana Med J. 2006 Sep;40(3):105-9. doi: 10.4314/gmj.v40i3.55262.
SummaryThree cases of retained fetal bones, the first two after mid-trimester termination of pregnancy and the third after dilatation and evacuation (D&E) of the uterus for a missed abortion, are presented. All the cases were complicated by secondary infertility. In all the cases the diagnosis was confirmed by a high resolution pelvic ultrasound scan. The pieces of bones were removed at dilatation and evacuation under general anaesthesia. In two of the cases pregnancy occurred within 6 months of removal of the bones. It is believed that bones retained freely in the endometrial cavity behave as an intrauterine contraceptive device (IUCD). Because of the many complications associated with mid-trimester dilatation and evacuation of the uterus, its role in modern gynaecology should be limited. It is suggested that retained fetal bones should be considered in the differential diagnosis of women presenting to infertility clinics when there is a history of mid-trimester D&E of the uterus.
摘要 本文介绍了三例胎儿骨骼残留病例,前两例发生在妊娠中期终止妊娠后,第三例发生在因稽留流产行子宫扩张刮宫术(D&E)后。所有病例均并发继发性不孕。所有病例均经高分辨率盆腔超声扫描确诊。在全身麻醉下行扩张刮宫术时取出骨骼碎片。其中两例在取出骨骼后6个月内怀孕。据信,自由残留于子宫内膜腔的骨骼起到了宫内节育器(IUCD)的作用。由于妊娠中期子宫扩张刮宫术存在诸多并发症,其在现代妇科中的作用应受到限制。建议当不孕门诊的女性有妊娠中期子宫D&E病史时,在鉴别诊断中应考虑胎儿骨骼残留。