Retained Intrauterine Fetal Bone Fragments as a Cause of Abnormal Uterine Bleeding: An Unusual Case Report

Introduction:Retention of fetal bones in the uterine cavity is a rare occurrence and almost always a consequence of second trimester termination of pregnancy

 Case: We report an unusual case of a 28 year old P1L1A3 lady who had a surgical termination of a 16 week pregnancy 4 months back and presented with abnormal uterine bleeding. She was anxious to conceive again. Transvaginal ultrasound revealed multiple linear calcific foci in the uterine cavity. Hysteroscopy showed presence of multiple flat fetal bones which were removed under vision. The patient was put on high dose oestrogen in postoperative period and conceived spontaneously 2 months after the procedure.

Conclusion: The differential diagnosis of retained fetal bones should be kept in mind in any woman presenting with abnormal uterine bleeding and difficulty in conception after a second trimester abortion. Also, this case highlights the need to avoid surgical termination of second trimester abortion unless it is it is done by a skilled person or done under ultrasound guidance.

Keywords: Retained fetal bones, Abnormal uterine bleeding, Hysteroscopy, Fertility.