|Perforation of the uterus is an accidental puncture of the uterus.|
Perforation is usually caused by a surgical instrument shaped like a spoon or scoop used for scraping and removing material from an organ (curette) or by an intrauterine device (IUD). There have been some cases of uterine perforation following induced abortion. The instrument penetrates through the uterine wall, and rarely, may migrate into the abdominal cavity where the bowel or bladder may also be perforated.
A woman's uterus can become perforated during other intrauterine procedures, such as rotating an infant during delivery using forceps, dilation and curettage (D&C) procedures in which the lining of the uterus is scraped, or during a tubal ligation sterilization procedure. During IUD insertion, perforations can occur when the uterus is abnormally positioned or unusually soft after a birth or abortion. An IUD can also become "lost" within the uterus, and the end of the device may pierce the muscular wall of the uterus.
Breastfeeding (lactating) women are at higher risk for perforation of the uterus during insertion of an IUD or with D&C and should be carefully monitored. During dilation and curettage procedures, postmenopausal women are at a higher risk for uterine perforation because the cervix narrows and the wall of the uterus become thinner after menopause.
Risk: Individuals who have had past abortions, C-sections, or other surgeries on the cervix have an increased risk for uterine perforation. The internal cervical os may become injured during these procedures, causing scar tissue formation and weakness of cervical tissues that may lead to increased susceptibility to perforation.
Incidence and Prevalence: Uterine perforation occurs in about 1 out of every 250 (0.4%) abortion procedures; the perforation rate is higher when abortions are performed in the second trimester (Trupin).
Source: Medical Disability Advisor