Demirtas Omer, Terzi Hasan, Kale Ahmet, Sanibrahim Bahar, Guler Omer Tolga
Department of Obstetrics and Gynaecology, Pamukkale University, Medical Faculty Hospital, Denizi, Turkey.
Department of Obstetrics and Gynaecology, Kocaeli Derince Research and Training Hospital, Kocaeli, Turkey.
J Pak Med Assoc. 2015 Oct;65(10):1119-21.
Unsafe abortion is one of the most neglected healthcare problems in developing countries. One of the rare complications of unsafe abortion is retained foetal bone. Prevalence of disease is around 0.15% among patients undergoing diagnostic hysteroscopy. Patients have no specific symptoms. Case reports have focused on subfertility, abnormal uterine bleeding, lower abdominal pain, abnormal vaginal discharge, dyspareunia, dysmenorrhoea and spontaneous passage of bony fragments. Retained foetal bone fragments may cause acute pelvic inflammatory disease in rare cases regardless of the time interval after abortion. This condition can also present as recurrent vagitinis or endometritis refractory to ampirical antimicrobial treatment. In such cases, foreign body in uterine cavity should be kept in mind. Such patients should primarily be evaluated by ultrasonography which has substantial clinical importance in differential diagnosis of these cases. We present a case of misdiagnosed retained foetal bone complicated with recurrent vaginal discharge and acute pelvic inflammatory disease.
不安全堕胎是发展中国家最被忽视的医疗保健问题之一。不安全堕胎的罕见并发症之一是胎儿骨骼残留。在接受诊断性宫腔镜检查的患者中，该病的患病率约为0.15%。患者没有特定症状。病例报告主要集中在不孕、异常子宫出血、下腹痛、异常阴道分泌物、性交困难、痛经和骨碎片自然排出。无论堕胎后的时间间隔如何，胎儿骨骼残留碎片在极少数情况下可能导致急性盆腔炎。这种情况也可能表现为复发性阴道炎或对经验性抗菌治疗无效的子宫内膜炎。在这种情况下，应考虑宫腔内异物。此类患者应首先通过超声检查进行评估，这在这些病例的鉴别诊断中具有重要的临床意义。我们报告一例误诊为胎儿骨骼残留并伴有复发性阴道分泌物和急性盆腔炎的病例。
