Establishing a Low-Budget Hysteroscopy Unit in a Resource-Poor Setting
Twin pregnancies are increasing due to assisted reproductive techniques. Following the death of one twin in-utero, the surviving and dead twin are removed from the uterine cavity at delivery. This is a report of a 38-year-old para 0+3 woman who experienced fetal demise of one of a set of twins at 20 weeks of gestation. She had an elective cesarean section during which the dead twin was forgotten in the uterine cavity. She presented with profuse vaginal discharge that was sterile on culture. An ultrasound scan showed the presence of several echogenic substances within the endometrial cavity. These substances were hysteroscopically removed and confirmed by histology to be fetal bones. The vaginal discharge subsequently stopped. In conclusion, uterine revision should always be performed during cesarean section to prevent such an occurrence.
Keywords: cesarean; fetal bones; hysteroscopy; retention; twin.
Conflict of interest statement
The author declares no conflicts of interest in this work.
- Pantaleoni DC. Vol. 8. London: Medical Press Circular; 1869. On endoscopic examination of the cavity of the womb; pp. 26–7. 8.
- Bhave Chittawar P, Franik S, Pouwer AW, Farquhar C. Minimally invasive surgical techniques versus open myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2014;10:CD004638. – PubMed
- Valle DC, Solano JA, Rodriguez A, Alonso M. Pain management in outpatient hysteroscopy. Gynecol Minim Invasive Ther. 2016;5:141–7.
- Di SpiezioSardo A, Calagna G, Di Carlo C. Tips and tricks in office hysteroscopy. Gynecol Minim Invasive Ther. 2015;4:3–7.
- Patil SG, Bhute SB, Inamdar SA, Acharya NS, Shrivastava DS. Role of diagnostic hysteroscopy in abnormal uterine bleeding and its histopathologic correlation. J Gynecol Endosc Surg. 2009;1:98–104. – PMC – PubMed