Operative hysteroscopy-assisted pregnancy termination after failed surgical abortion in missed abortion of woman with complete septate uterus

• Published in: Obstetrics & gynecology science Vol. 63; no. 1; pp. 102 - 106
• Main Authors: Ryu, Soomin, Baek, Hye Won, Lee, Inha, Won, Young Bin, Kim, Heeyon, Lee, Jae Hoon, Yun, Bo Hyon, Park, Joo Hyun, Seo, Seok Kyo, Cho, SiHyun, Choi, Young Sik, Lee, Byung Seok
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Obstetrics and Gynecology; Korean Society of Contraception and Reproductive Health; Korean Society of Gynecologic Endocrinology; Korean Society of Gynecologic Endoscopy and Minimal Invasive Surgery; Korean Society of Maternal Fetal Medicine; Korean Society of Ultrasound in Obstetrics and Gynecology; Korean Urogynecologic Society 01-01-2020; Korean Society of Obstetrics and Gynecology; 대한산부인과학회
• Subjects: Case Report; hysteroscopy; induced abortion; missed abortion; septate uterus; uterine anomalies; 산부인과학; Hysteroscopy; Uterine anomalies; Missed abortion; Septate uterus; Induced abortion
• ISSN: 2287-8572; 2287-8580
• DOI: 10.5468/ogs.2020.63.1.102

First trimester surgical abortion is an effective and safe procedure. Although its failure is uncommon, congenital uterine anomaly may be considered as one of the etiologic factors in such cases. Here, we report a rare case of surgical abortion failure that was successfully managed by operative hysteroscopy-assisted dilatation and evacuation (D&E) under ultrasound guidance in a woman with complete uterine septum. The patient was referred to Severance Hospital after two consecutive surgical abortion failures even under ultrasound guidance. A missed abortion in a left-sided hemicavity of septate uterus was noted on ultrasonography. Ultrasound-guided D&E was unsuccessful because the curette could not reach the uterine cavity with the gestational sac. Operative hysteroscopy revealed insufficient communication with the left-sided cavity just above the cervical internal os of the uterine septum. After widening the communication, ultrasound-guided D&E was successfully performed.