Pregnancy following endometrial ablation

Case report A 29-year-old woman who refused medical treatment for menorrhagia underwent a transcervical endometrial ablation. The procedure was performed using an operating hysteroscope and rollerball diathermy. Her previous obstetric history included eight miscarriages and three caesarean sections, the last being in 1992. The patient was given contraceptive advice but ignored this and spontaneously conceived 6 months postoperatively. Her periods after the ablation had been reduced to monthly spotting . Serial scans in pregnancy indicated intrauterine growth restriction (IUGR). The placenta was normally implanted with no features of accreta or increta seen. An elective caesarean section was performed at 34 weeks because of IUGR. The operation was uneventful and a female infant weighing 1515 grams with Apgar scores of 6 at 1 minute and 8 at 5 minutes was delivered. The cleavage at placental separation was satisfactory and the placenta appeared complete. The woman had an uneventful postoperative recovery. The infant was admitted to the special care unit with features of mild respira tory distress syndrome, and was discharged home after 3 weeks.