Induction of abortion following radiofrequency ablation of the endometrium: A case report and search for evidence-based practice

Abstract

Objectives Pregnancy following endometrial ablation is a rare event that carries significant risks to the mother. The majority of women elect to terminate such pregnancies. This brings into question which of the available methods should best be employed and what kinds of problems to anticipate.

Case We present a case of a pregnancy following radiofrequency endometrial ablation that was terminated surgically and review the relevant English literature.

Conclusions Medical or surgical abortion can be considered as primary methods of terminating a first trimester intrauterine pregnancy following endometrial ablation. The choice will depend on patient preference but also on the available expertise. Cervical stenosis and/or intrauterine adhesions may limit the effectiveness of these methods. In such cases methotrexate is an alternative option, whereas hysterotomy or hysterectomy should be considered as final options. Counselling patients at the time of endometrial ablation regarding the need for contraception, even after prolonged periods of amenorrhoea is of paramount importance. Laparoscopic or hysteroscopic sterilisation can be offered together with endometrial ablation.

Keywords:

• Endometrial ablation
• Medical abortion
• Surgical abortion
• Termination of pregnancy

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.