[Uterine perforation and vesical migration of an intrauterine device. Case observation].

PIP: A case of uterine perforation, caused by a TCu 200 IUD which emigrated to the urinary bladder, is reported. It was extracted by transuretral endoscopy after term pregnancy and delivery. Such accidents are rare, but according to the literature are more frequent with some devices like the Birnberg Bow than with others such as Lippes Loops. Certain factors contributing to the possibility of perforation are inept insertion or positioning, fragility of the uterine wall due to recent birth or abortion, or pregnancy. Symptoms may be nonexistent. Conversely, it can cause severe pain or problems like intestinal obstruction or uterine lesion.^ieng

[Medical and ethical considerations on repeated cesarean section. Apropos of a 7th cesarean]. / Consideraciones médicas y deontológicas en torno a la cesárea iterativa. A propósito de una séptima cesárea.

PIP: After performing a 7th caesarean section on a patient, the authors reviewed the literature on repeated caesarean sections and examined medical and ethical arguments concerning the appropriateness of sterilization in such cases. They state that the patient did not request sterilization, and are in principle opposed to it even in such cases. In view of current medical progress, they regard the operation as generally safe and the risks involved similar to those normally faced during pregnancy. Sterilization should be performed only when justified by other medical reasons, in addition to the fact that the patient has required repeated caesarean sections.^ieng