Background: The presence of intrauterine bone fragments is a rare condition. Abnormal uterine bleeding from retained fetal bone is an even more rare condition. Case: A 34-year-old para 3, abortus 1, married woman presented with abnormal uterine bleeding (AUB) in the form of polymenorrhea and hypomenorrhea. Bimanual examination revealed a normal size uterus and normal adnexae. Hysteroscopy revealed multiple tiny bony chips in the uterine cavity, which were evacuated. Correlating with the past history, it was concluded that the patient had retained fetal bony fragments during a second trimester dilation and evacuation (D&E), leading to AUB. Results: Removal of the fragments by curettage regularized her menstrual cycle. Conclusions: when D&E is used, pelvic ultrasonography (USG) must be performed to confirm uterine emptiness. The important role of routine pelvic USG, or, where facilities exist, routine hysteroscopy for AUB, especially for those patients with a history of mid-trimester D&E, is emphasized, as retained fetal bone can present with AUB. (J GYNECOL SURG 29:330)
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