[Laparoscopy in the treatment of uterine perforation in induced abortions]

From 1981 to 1988, 32 uterine perforations per 44,052 artificial abortions (0.07%) were recorded. Also three more perforations having occurred outside the Department were treated. In two patients the perforation was done by a probe and the evacuation of the uterus was completed vaginally. Six perforations were in the parametrium, producing no injury of the serosa; three of them required laparotomy because of abundant bleeding (laparotomy had to be applied previously in the two) and in the remaining 27 patients the uterine corpus was perforated either by a dilatator, forceps, curette or aspiration cannula. If the injuries of the abdominal organs were evident, laparotomy was applied in the first place (in two patients) and the same was done in perforations by the aspiration canulla with the inclusion of the negative pressure (three patients). In 28 patients laparoscopy was applied, three of them having been selected for laparotomy. Out of the remaining 25 patients, the perforation opening in 22 was treated endothermically by the low voltage current or electrocoagulation by a probe of high frequency current to stop bleeding. In three patients the uterus was adequately contracted, there was no bleeding from the edges of the perforation opening and therefore no coagulation was necessary.