Retained Foetal Bone Fragment Masquerading as Foreign Body Causing Secondary Infertility

Abstract

Background: Termination of pregnancy is on the rise in India, due to variety of safer abortion techniques, and readily available facilities. When conducted correctly, pregnancy termination (abortion) is a relatively safe treatment. Pregnancy termination is linked to immediate and delayed problems such as haemorrhage and uterine perforation, as well as Asherman's syndrome, menstrual irregularities, and secondary infertility. However, difficulties can occur even when procedures are carried out with the utmost care. The retention of foetal products after a mid-trimester abortion is an uncommon abortion complication that can lead to subsequent infertility. In rare situations, retained foetal bone fragments can induce acute pelvic inflammatory disease, regardless of how long it has been after the abortion. Recurrent vaginitis or endometritis that is resistant to empirical antibiotic treatment can also be symptoms of this illness. In such circumstances, the possibility of a foreign body in the uterine cavity should be considered. Ultrasonography should be used to evaluate such individuals first, as it is crucial in the differential diagnosis of these situations. Case: We hereby present a case of a 25-year-old lady who had an abortion at the 14th week of pregnancy due to anencephaly in the baby and thereafter was unable to conceive for the next five years. The presence of a suspected foreign body or endometrial calcification in the upper uterine cavity was discovered during a transvaginal Ultrasonographic examination and was removed hysteroscopically. Following the hysteroscopic removal of bone piece, the patient was able to conceive. Remaining bone pieces from a prior mid-trimester abortion thus should be added to the list of secondary infertility differentials. Objectives: We evaluated the relevant causative factors, radiographic abnormalities, treatment strategies and clinical recovery in secondary infertility Conclusions: Secondary infertility caused by retained foetal bones is an uncommon occurrence that an obstetrician should be aware of while evaluating patients who have had a previous mid-trimester abortion. For initial diagnosis, transvaginal ultrasonography is a useful tool. Hysteroscopy is useful for both diagnostic and therapeutic purposes. The majority of these patients should be able to conceive again. In the post-abortion phase, all patients who had a second-trimester abortion should get a trans-vaginal ultrasound to confirm full evacuation of all the products of conception.