Abstract
IntroductionIntrauterine fetal bone retention is a rare complication and the bony fragments probably work like an intrauterine contraceptive device resulting in secondary infertility. Among the scarcely reported cases in the literature, there was no report described the retention of a large number of fetal bones with nearly intact morphology.Case presentationThe present report described an unusual case of fetal bone retention in a 30-year-old infertile Chinese woman who had a surgical termination of a 15-week pregnancy 9 years ago. The routine B-ultrasound diagnosed intrauterine foreign bodies. A hysteroscopy was performed which showed a large number of intrauterine bony fragments, with clear fetal skeletal outline and intact morphology. The detected residual fetal bones were removed under hysteroscopy, assisted by B-ultrasound scanning. The patient was pregnant 5 months later. The present case confirms the importance of routine examination of the intactness of the fetus after abortion, particularly when it happens in pregnancies of more than 12 weeks. Once diagnosed, the detected residual fetal bones should be removed by surgery, mainly under hysteroscopy.ConclusionsThe retention of fetal bone may cause infertility, and removal of the residual bone may restore fertility. The improvement in hysteroscopy made it feasible to diagnose and remove the bones. The present case highlights the importance of examining the intactness of the removed fetus.
Highlights
Intrauterine fetal bone retention is a rare complication and the bony fragments probably work like an intrauterine contraceptive device resulting in secondary infertility
The present case highlights the importance of examining the intactness of the removed fetus
The bony fragments probably work like an intrauterine contraceptive device (IUCD) to stimulate the secretion of endometrial prostaglandins, resulting in secondary infertility [2,3]
Summary
The retention of fetal bone may cause infertility, and removal of the residual bone may restore fertility. The improvement in hysteroscopy and the application of imaging technology made it feasible to diagnose and remove the bones and obtain clear intrauterine pictures. The operation should be conducted under ultrasound monitoring to ensure the removal of the retained fetal bones and to reduce the possibility of complications such as uterine perforation. The present case highlights the importance of examining the intactness of the removed fetus, when the abortion happened with a pregnancy longer than 12 weeks. Consent Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Authors’ contributions SX participated in the design of diagnosis and treatment plan, surgical operation, and drafted the manuscript. MX guided the manuscript draft and surgical operation. All authors read and approved the final manuscript
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