Case Report

Management of vaginal wall perforation during a second trimester dilation and evacuation

Authors: Heather R. Williams (University of Iowa Carver College of Medicine, Iowa City, Iowa) , Abbey J Hardy-Fairbanks (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa) , Colleen K. Stockdale (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa) , Stephanie Radke (University of Iowa Hospitals and Clinics, Department of Obstetrics and Gynecology, Iowa City, Iowa)

  • Management of vaginal wall perforation during a second trimester dilation and evacuation

    Case Report

    Management of vaginal wall perforation during a second trimester dilation and evacuation

    Authors: , , ,

Abstract

Background: We report an unusual case involving vaginal perforation associated with second trimester dilation and evacuation. Review of the literature fails to identify additional reports.

Case: A 22 year G3P1011 female at 16 weeks gestation referred for evaluation following incomplete dilation and evacuation was found to have vaginal perforation, and communication with the peritoneal cavity on pelvic examination. Examination under anesthesia and laparoscopy confirmed multiple vaginal perforations with intraperitoneal defects and hematomas but no viscus involvement. Cervical dilation was accomplished with osmotic dilators placed under ultrasound guidance during exam under anesthesia, with evacuation completed approximately 16 hours later without further complication.

Conclusion: This is the first case of vaginal perforation at time of dilation and evacuation reported in the literature. Laparoscopy should be performed to evaluate for intraabdominal injury to bowel, bladder and/or blood vessels. Use of osmotic dilators during the second trimester could potentially decrease the risk of vaginal perforation during the dilation portion of the procedure.

Keywords: Vaginal perforation, laparoscopy, therapeutic abortion, pregnancy, dilation and evacuation

How to Cite:

Williams, H. R. & Hardy-Fairbanks, A. J. & Stockdale, C. K. & Radke, S., (2017) “Management of vaginal wall perforation during a second trimester dilation and evacuation”, Proceedings in Obstetrics and Gynecology 7(3), 1-7. doi: https://doi.org/10.17077/2154-4751.1375

Rights: Copyright © 2017 the authors

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Published on
01 Oct 2017
Peer Reviewed
License
CC BY 4.0