This young female patient had had a recent surgical termination of pregnancy performed elsewhere and had presented to our institution in extremis. 

Uterine perforation is fortunately rare and may be either iatrogenic or a spontaneous event. Iatrogenic causes include virtually any O&G procedure including dilatation and curettage (D&C), hysteroscopy, IUCD insertion, etc. Spontaneous perforation is rarer and etiologies include gestational trophoblastic disease, pyometra, placenta accreta or even degenerating fibroid.

Uterine perforation following surgical termination of pregnancy is a rare event, usually in women that have had previous gynecological surgery ¹. More rarely still is the passage of fetal parts into the abdominal cavity, with little in the published literature ^2,3. In some cases of iatrogenic uterine perforation the perforation goes unrecognised during the initial procedure. D&C is considered a well-tolerated procedure with a low incidence of complications. Uterine perforation has been reported to occur in 0.07 to 1.2% cases ³.