Wohlmuth Cinna Toy, Myers Tikvah
Department of Obstetrics and Gynecology, White Memorial Medical Center, 1720 Cesar E. Chavez Avenue, Los Angeles, CA 90033, USA.
J Reprod Med. 2011 Sep-Oct;56(9-10):444-55.
Retained fetal parts is an uncommon but recognized complication of pregnancy termination. A case of retained fetal bones, 2 years after midtrimester dilation and evacuation (D&E), is described and utilized as a nidus for literature search and discussion of clinical presentation variations.
A 27-year-old woman, G2, P1, A1, presented complaining of a 2-year history of vaginal discharge. After visiting several healthcare providers and receiving ultrasound evaluations followed by courses of antibiotics and oral contraceptives, the patient's symptoms persisted. Subsequent hysteroscopy revealed fragments of immature bone. Symptoms resolved after hysteroscopic removal of the bone fragments.
Retained fetal parts can present with a variety of clinical symptoms and signs, including chronic pelvic pain, vaginal discharge, and secondary infertility. When symptoms are nonspecific, the condition can mimic other gynecologic conditions. Multiple case reports have described postabortal removal of retained fetal bone at varying time intervals from the antecedent D&E, ranging from days to years. The symptomatic presentation can be temporally remote from the antecedent abortion, and symptoms can mimic other common gynecologic conditions. The entity presents the gynecologist with diagnostic and therapeutic challenges.
残留胎儿组织是一种罕见但已被认识到的终止妊娠并发症。本文描述了一例在孕中期扩张刮宫术后2年残留胎儿骨骼的病例，并以此为切入点进行文献检索及对临床表现差异的讨论。
一名27岁女性，孕2产1，人流1次，主诉有2年的阴道分泌物异常病史。在就诊于多位医疗服务提供者并接受超声检查，随后使用抗生素及口服避孕药治疗后，患者症状仍持续存在。随后的宫腔镜检查发现了未成熟的骨碎片。在宫腔镜下取出骨碎片后症状得以缓解。
残留胎儿组织可表现为多种临床症状和体征，包括慢性盆腔疼痛、阴道分泌物异常及继发性不孕。当症状不具特异性时，该病症可能会被误诊为其他妇科疾病。多篇病例报告描述了在不同时间间隔（从数天到数年）从先前的扩张刮宫术后取出残留胎儿骨骼的情况。症状表现可能在先前流产后很长时间才出现，且症状可能类似于其他常见的妇科疾病。该病症给妇科医生带来了诊断和治疗方面的挑战。
