Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria

Background. In 2013, the abortion rate in the United States was found to be 200 abortions per 1,000 live births. Of these, the CDC estimates that nearly 49% were performed using unsafe measures. Even when these procedures are safely performed, patients are at risk for immediate or delayed complicati...

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Main Authors: Wesley Nilsson, Sasha Mikhael, Jennifer Kaplan
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Obstetrics and Gynecology
Online Access:http://dx.doi.org/10.1155/2017/6345712
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author Wesley Nilsson
Sasha Mikhael
Jennifer Kaplan
author_facet Wesley Nilsson
Sasha Mikhael
Jennifer Kaplan
author_sort Wesley Nilsson
collection DOAJ
description Background. In 2013, the abortion rate in the United States was found to be 200 abortions per 1,000 live births. Of these, the CDC estimates that nearly 49% were performed using unsafe measures. Even when these procedures are safely performed, patients are at risk for immediate or delayed complications. In second-trimester terminations, mechanical dilation with an osmotic dilator is common to allow for delivery of the fetus. The Japanese seaweed Laminaria japonica is used to achieve this purpose. Case. A 28-year-old primigravida presented with chronic pelvic pain and infertility. She had irregular menstrual cycles and reported scant yellow discharge. A transvaginal ultrasound revealed an abnormally appearing endometrium with an elongated structure suspicious for a foreign body. The patient reported a voluntary termination of pregnancy twelve years earlier, for which laminaria were placed prior to the dilation and extraction. She underwent an operative hysteroscopy confirming our suspicion for retained laminaria. The pathology report demonstrated chronic severe endometritis and plant based material. Conclusion. Retained laminaria are associated with chronic pelvic pain and chronic infertility. Since they can be difficult to detect on conventional imaging, proper counting prior to insertion and after removal is an essential physician responsibility.
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spelling doaj-art-457aa35ca91d4fbcaca93a422f675f2e2025-08-20T03:36:10ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922017-01-01201710.1155/2017/63457126345712Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained LaminariaWesley Nilsson0Sasha Mikhael1Jennifer Kaplan2American University of the Caribbean, Coral Gables, FL, USADepartment of Obstetrics and Gynecology, Providence Hospital, Michigan State University College of Human Medicine, East Lansing, MI, USADepartment of Obstetrics and Gynecology, Providence Hospital, Michigan State University College of Human Medicine, East Lansing, MI, USABackground. In 2013, the abortion rate in the United States was found to be 200 abortions per 1,000 live births. Of these, the CDC estimates that nearly 49% were performed using unsafe measures. Even when these procedures are safely performed, patients are at risk for immediate or delayed complications. In second-trimester terminations, mechanical dilation with an osmotic dilator is common to allow for delivery of the fetus. The Japanese seaweed Laminaria japonica is used to achieve this purpose. Case. A 28-year-old primigravida presented with chronic pelvic pain and infertility. She had irregular menstrual cycles and reported scant yellow discharge. A transvaginal ultrasound revealed an abnormally appearing endometrium with an elongated structure suspicious for a foreign body. The patient reported a voluntary termination of pregnancy twelve years earlier, for which laminaria were placed prior to the dilation and extraction. She underwent an operative hysteroscopy confirming our suspicion for retained laminaria. The pathology report demonstrated chronic severe endometritis and plant based material. Conclusion. Retained laminaria are associated with chronic pelvic pain and chronic infertility. Since they can be difficult to detect on conventional imaging, proper counting prior to insertion and after removal is an essential physician responsibility.http://dx.doi.org/10.1155/2017/6345712
spellingShingle Wesley Nilsson
Sasha Mikhael
Jennifer Kaplan
Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
Case Reports in Obstetrics and Gynecology
title Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
title_full Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
title_fullStr Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
title_full_unstemmed Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
title_short Chronic Pelvic Pain and Infertility Resulting from Unrecognized Retained Laminaria
title_sort chronic pelvic pain and infertility resulting from unrecognized retained laminaria
url http://dx.doi.org/10.1155/2017/6345712
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