Abstract
INTRODUCTION: Retained fetal bones are a rare complication following second-trimester dilation and curettage (D&C). This condition can lead to chronic endometrial inflammation and secondary infertility, often presenting years later. Missed diagnoses are especially common in low-resource settings due to limited follow-up and diagnostic capacity. PRESENTATION OF CASES: We present two cases of women with histories of second-trimester pregnancy loss managed with D&C, later diagnosed with retained intrauterine fetal bones.Case 1: A 30-year-old woman, Gravida 5, Para 2, presented 2 weeks post-abortion with ultrasound findings of hyperechogenic structures in the endometrial cavity. Hysteroscopy confirmed and removed multiple bone fragments.Case 2: A 29-year-old woman, Gravida 3, Para 0, presented with 6 years of secondary infertility. Ultrasound revealed echogenic material in the uterine cavity. Operative hysteroscopy removed calcified fetal remnants. Both patients had successful hysteroscopic removal and resumed normal menses postoperatively. DISCUSSION: Retained fetal bones act as intrauterine foreign bodies, causing secondary infertility through mechanical obstruction, chronic inflammation, and impaired endometrial receptivity. Delayed diagnosis is common due to nonspecific symptoms and limited access to imaging. These cases highlight systemic gaps in post-abortion care, including inadequate follow-up and provider awareness. CONCLUSION: These cases highlight the need to consider retained fetal bones in women with unexplained infertility and a prior history of second-trimester abortion. Routine post-procedure imaging and structured follow-up protocols are crucial for timely diagnosis and management, especially in resource-limited settings.