CLINICAL CASE OF SILENT UTERINE PERFORATION AFTER INNECTORAL CONTRACEPTIVES PLACEMENT IN ANAMNESIS

Abstract

The most dangerous complication when using intrauterine contraceptives is the perforation of the uterus. According to the WHO expert group, uterine perforation in contraceptive carriers is associated with significant frequency fluctuations (one case per 1509,000 placements). The frequency of perforations depends on the type of contraceptive, the material from which it is made, as well as on the anatomical features of the uterus (retroflexion of the uterus, scar narrowing and deformation of the cervical canal, deformation of the external cervical os after diathermocoagulation of the cervix, etc.).Uterine perforation usually occurs in three places: at the bottom of the uterus, in the corner between the cervix and its body and at the wall of the cervix (WHO data, 2005).A clinical case of "silent uterine perforation" has been published to avoid or reduce the incidence of complications with the placement and use of intrauterine contraceptives. The article presents a clinical case of detected uterine perforation with uterine contraceptive, which has been asymptomatic for 10 years and has been diagnosed as an accidental finding during surgery for large size uterine fibroids. The anamnesis data, description of the clinical picture and features of the course of surgery are given; ways of prevention of this complication are discussed. Analyzing the clinical case, the authors concluded that in order to prevent the above complications, it is necessary to verify the localization of the intrauterine contraceptivewith the ultrasound after its placement. In case of difficulty in removing the intrauterine contraceptive, this procedure may be performed under the control of a hysteroscope.