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Intrauterine retention of fetal bones after abortion

In 1994 in Sweden 4 women who had idiopathic secondary infertility were referred to the obstetrics and gynecology department of Karolinska Hospital in Stockholm. In all 4 cases the women had a history of induced or spontaneous abortion. Vacuum aspiration or curettage were used to remove the conceptus during the 1st or early 2nd trimester of pregnancy. Hysteroscopic examination in all 4 patients revealed fetal bones in the uterus. The retained bones were removed. The interval between abortion and discovery of retained fetal bones following an earlier abortion ranged from 1 year to 15 years. Three cases suffered from uterine bleeding other than during menstruation. This uterine bleeding and history of infertility were the reasons for referral to a gynecologist. The husband of the case who had suffered a spontaneous abortion felt a sharp structure in the vagina during intercourse precipitating the visit to the gynecologist. The retained fetal bones in the uterus likely caused prolonged endometrial inflammation with severe intrauterine adhesions and infertility. Hysteroscopy allows gynecologists to diagnose retained fetal bones to evaluate the uterine cavity and to remove the fetal bones.