Retained plastic instrument after 5 years of illegal abortion: a case report and literature review

Randriamahavonjy Romuald, Tanjona A. Ratsiatosika, Rasolofomanana Sonia, Ravelojaona Andriniaina, Rakotonirina Mahefa, Rainibarijaona A. Lantonirina, Rakotonirina Ando-Miora, Andrianampanalinarivo H. Rakotovao


The retained of a foreign body during a surgical procedure is defined by the forgetting of a material, left by inattention in the body of the patient during this act. It is a rare event but is responsible for high morbidity and mortality. Authors report a retained foreign body incidentally discovered during a caesarean section. The patient had performed an illegal abortion by endo-uterine instrument which was complicated by uterine perforation five years previously. She was pregnant at 37 weeks and presented to the emergency department for bleeding and diagnosed as placenta previa. The antecedent of abortion had not been informed because it is an illegal act in Madagascar. The plastic instrument was in the broad ligament in contact with the ureter and the uterine artery. Caesarean section, the removal of the catheter and postoperative recovery was uneventful. Foreign body retention remains a malpractice and the diagnosis must be made in the face of chronic pain in patients who have undergone surgery.


Clandestine abortion, Foreign body, Retained surgical instrument, Uterine perforation

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Elsharydah A, Warmack KO, Minhajuddin A, Moffatt-Bruce SD. Retained surgical items after abdominal and pelvic surgery: Incidence, trend and predictors- observational study. Ann Med Surg. 2016;12:60-4.

Popovic JR, Hall MJ. National Hospital Discharge Survey. Advance data from vital and health statistics. No. 319. Hyattsville, Md.: National Center for Health Statistics, 2001. (DHHS publication no. (PHS) 2001-1250 1-0287. 1999.

Gawande AA, Studdert DM, Orav EJ, Brennan TA, Zinner MJ. Risk factors for retained instruments and sponges after surgery. N Engl J Med. 2003;348:229-35.

Doh K, Thiam I, Takin RCA, Bissirou I, Gaye GW. A case of renal textiloma simulating an anatomopathological discovery tumor. Afr J Urol. 2017.

Rakotondraisoa JM, Andrianampy HA, Rajaonarison JJC, Randriambelomanana. JA. Complications of illegal abortions seen at the University Hospital of Gynecology and Obstetrics of Befelatanana, Antananarivo. Rev Med Madag. 2013;3(2):273-7

Diallo MH, Balde IS, Diallo MC, Baldé O, Barry AB, Keita FS, et al. Clandestine induced abortions: sociodemographic aspects, complications and care at the Mamou Regional Hospital, Guinea. Rev Int Sc Med. 2016;18(4):259-64.

Nlome-Nze AR, Picaud A, Mbadinga A, Ogowet N, Engongah-Beka T. Clandestine abortions in Libreville: a real public health problem. Med Afr Noire. 1991;38(3):223-7.

The Care of Women Requesting Induced Abortion (Evidence-based Clinical Guideline No. 7). Royal College of Obstetricians and Gynecologists; 2011.

Faucher. Complications of voluntary termination of pregnancy. J Gynécol Obstét Biol Reprod. 2016;45:1536-51.

Ravolamanana Ralisata L, Rabenjamina FR, Razafintsalama DL, Rakotonandrianina E, Randrianjafisamindrakotroka NS. Post-abortal peritonitis and pelvic peritonitis at Androva Mahajanga Teaching Hospital: about 28 cases. J Gynecol Obstet Biol Reprod. 2001;30:282-7.

Lovrec VG, Cokan A, Lukman L, Arko D, Takac I. Retained surgical needle and gauze after cesarean section and adnexectomy: a case report and literature review. J Int Med Res. 2018.

Yildirim T, Parlakgumus A, Yildirim S. Diagnosis and management of retained foreign objects. J Coll Physicians Surg Pak. 2015;25:367-71.

Lebas L, Dupuis M, Solovei L, Jaffro M, Grunenwald E, Pontier-Marchandise S. Twenty years later. . . History of an intra-thoracic textilome. Rev Mal Respir. 2018.

Steelman VM, Shaw C, Shine L, Hardy-Fairbanks A. Unintentionally retained foreign objects: a descriptive study of 308 sentinel events and contributing factors. Joint Commission J Quality Patient Safety 2018:1-10.

Ananth C, Smulian J, Vintzileos A. The association of placenta previa with history of cesarean delivery and abortion: a meta-analysis. Am J Obstet Gynecol. 1997;177:1071-8.