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The patient had no postoperative complications and was discharged 2\u2009days later. This case illustrates a rare cause of unsuccessful abortion due to interfering fibroids and outlines hysterotomy as an effective secondary evacuation strategy for complicated second trimester abortions, particularly when products of conception are still present.<\/jats:p>","DOI":"10.1136\/bcr-2025-268796","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T10:55:19Z","timestamp":1766487319000},"page":"e268796","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Transfundal hysterotomy after an unsuccessful dilation and evacuation procedure due to uterine fibroids"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3776-2213","authenticated-orcid":false,"given":"Sarah","family":"Battiston","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Thewani","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Gear","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Stanton","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, Henry Ford Health System, Detroit, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"2026022401300958000_18.12.e268796.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.ss7307a1","article-title":"Abortion Surveillance \u2014 United States, 2022","volume":"73","author":"Ramer","year":"2024","journal-title":"MMWR Surveill Summ"},{"key":"2026022401300958000_18.12.e268796.2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.bpobgyn.2019.05.006","article-title":"Current and potential methods for second trimester abortion","volume":"63","author":"Lerma","year":"2020","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"2026022401300958000_18.12.e268796.3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss7105a1"},{"key":"2026022401300958000_18.12.e268796.4","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/AOG.0000000000000945","article-title":"Abortion-Related Mortality in the United States","volume":"126","author":"Zane","year":"2015","journal-title":"Obstet Gynecol"},{"key":"2026022401300958000_18.12.e268796.5","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s00404-025-08053-z","article-title":"Advancing knowledge and public health: a scientific exploration of abortion safety","volume":"312","author":"Recker","year":"2025","journal-title":"Arch Gynecol Obstet"},{"key":"2026022401300958000_18.12.e268796.6","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1097\/GRF.0000000000000825","article-title":"Second-trimester Abortion","volume":"66","author":"Swantic","year":"2023","journal-title":"Clin Obstet Gynecol"},{"key":"2026022401300958000_18.12.e268796.7","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1097\/01.AOG.0000431056.79334.cc","article-title":"Second trimester abortion. practice bulletin No. 135. 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