Assuntos
Íleo , Atresia Intestinal/complicações , Perfuração Intestinal/etiologia , Peritonite/etiologia , Abdome , Adulto , Feminino , Fístula/etiologia , Humanos , Recém-Nascido , Masculino , Mecônio , Gravidez , EscrotoRESUMO
PIP: A case of perforation of the uterus at the time of insertion of the Birnberg bow IUD in a lactating, amenorrheic woman is presented. The patient, a 25-year-old gravida 2, had the IUD inserted 2 months after delivery. Perforation occurred at the time of insertion, causing a 2 mm puncture wound in the fundus. It appeared that the perforation was caused by the expulsion of the bow from the introducer, not by uterine dilation. Although the patient's uterus appeared grossly normal and well involuted, it was extremely soft. This case raises questions about the timing of the insertion of an IUD in a lactating, amenorrheic woman. It has been commonly assumed that involution requires about 6 weeks and that lactation speeds this process. However, it is recommended that this assumption be reassessed and that insertion of any IUD be delayed until regular menses have been re-established.^ieng
