Uterine Perforation During Dilation and Evacuation Prior to Fetal Extraction--Now What? A Case Report

Uterine perforation is an infrequent but serious complication of dilation and evacuation (OE). The purpose of this case report is to describe management strategies once a uterine perforation is identified.A 15-year-old female at 15 weeks' gestation presented to a freestanding clinic for elective abortion. After serial cervical dilation, omentum was seen in the suction curette. The patient was transferred to a nearby hospital, she underwent an exploratory laparotomy. A 1.5-cm anterior uterine perforation was found. The uterus was evacuated under direct visualization prior to repair of the defect.Uterine perforation during DE often requires laparotomy to repair the defect and to evaluate for injury to adjacent organs. Evacuation can be completed transcervically under direct visualization or through the perforation site.