Symptoms of perforation of the uterus vary from minimal to severe abdominal pain, shoulder tip pain and shock. Pain may occur immediately or may be delayed depending on intraperitoneal bleeding and infection.
Perforation may be caused by IUCD insertion especially post-partum, uterine sounding and instrumentation during termination of pregnancy or dilatation and curettage. IUCDs can migrate through the myometrium.
A small perforation may heal but significant haemoperitoneum, infection or lost IUCD require laparotomy.
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