Removal of Retained Multiple Fetal Bones by Hysteroscopy

Abstract

A 28-year-old woman with a history of a previous pregnancy termination at 14 weeks gestational age 8 years earlier presented with secondary infertility. She reported regular periods that were painful despite normal flow, but no other complaints. An infertility evaluation was notable for ultrasonography demonstrating hyperechoic areas in the uterine cavity suspicious for fetal bones (Fig. 1), presumably from the previous pregnancy. On hysteroscopy, multiple fetal bones were seen in uterine cavity, some buried in myometrium (Fig. 2). A total of 17 fetal bones were removed via hysteroscopic graspers (Fig. 3) without incident.Fig. 2Hysteroscopy image.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig. 3Final image of the specimen.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Retained fetal bones may be asymptomatic, making them difficult to identify. These fragments may act like an intrauterine contraceptive device to prevent pregnancy. Hysteroscopy should be performed for accurate diagnosis and treatment.