Retained bones of the second twin following a cesarean section: a case report

Twin pregnancies are increasing due to assisted reproductive techniques. Following the death of one twin in-utero, the surviving and dead twin are removed from the uterine cavity at delivery. This is a report of a 38-year-old para 0(+3) woman who experienced fetal demise of one of a set of twins at 20 weeks of gestation. She had an elective cesarean section during which the dead twin was forgotten in the uterine cavity. She presented with profuse vaginal discharge that was sterile on culture. An ultrasound scan showed the presence of several echogenic substances within the endometrial cavity. These substances were hysteroscopically removed and confirmed by histology to be fetal bones. The vaginal discharge subsequently stopped. In conclusion, uterine revision should always be performed during cesarean section to prevent such an occurrence.