Inversión uterina puerperal crónica / Chronic puerperal uterine inversion

La inversión uterina es una entidad clínica poco frecuente y grave, descrita como una emergencia obstétrica relacionada con las complicaciones del tercer estadio del parto que necesita tratamiento inmediato, habitualmente quirúrgico. Con este artículo se pretende demostrar a la comunidad científica algunos elementos relacionados con esta, pues es probable que por su baja incidencia, generaciones actuales de obstetras no alcancen asistir una paciente con esta complicación, además por la ausencia de reportes nacionales relacionados con esta entidad. Se presenta una paciente que acudió al hospital, a los 2 meses después del parto, se diagnosticó una inversión uterina puerperal crónica grado II, fue necesario realizar la histerectomía total como tratamiento definitivo, lograron conservarse ambos anejos. La forma de presentación atípica en el cuadro clínico de esta paciente y la posibilidad de mostrar una evidencia gráfica de su presentación clínica y tratamiento quirúrgico, motivaron la presentación de este trabajo.

Uterine inversion is a rare and severe clinical entity described related to obstetric emergency in labor third stage complications, which needs immediate treatment, usually surgery. This article aims to show the scientific community some elements related to this, since it is likely that due to its low incidence, current generations of obstetricians do not assist patients with this complication, apart from the absence of national reports related to this entity. A patient came to the hospital 2 months after delivery, A chronic puerperal uterine inversion grade II was diagnosed. Total hysterectomy was necessary to perform as definitive treatment, achieving to retain both ovaries. The atypical presentation in this patient clinical condition and the ability to display graphic evidence of its clinical presentation and surgical treatment led to the presentation of this paper.

Inversión uterina secundaria a legrado por aspiración de embarazo molar en una paciente adolescente / Uterine inversion secondary to suction curettage of molar pregnancy in an adolescent patient

La inversión uterina puerperal es una condición médica rara que ocurre con una frecuencia de 1 en 2,000 embarazos, sin embargo la inversión uterina no puerperal es aún más rara y se encuentra frecuentemente en pacientes mayores de 45 años y asociada a tumores. Se presenta el caso de una paciente de 15 años, primigesta, a quien se le realizó un legrado por aspiración endouterina por un embarazo molar y durante el procedimiento presentó inversión uterina. La paciente formo un anillo de constricción, por lo que la inversión fue resuelta con la técnica de Hualtain...

Uterine Inversion : a Case Report

The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However; extrinsic factors such as oxytocic arrests after a prolonged labour; umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity; uterine hypotonia; various placental localizations; fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage; shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home

Inversion uterine: une cause inhabituelle d'hemorragie de la delivrance

L'inversion uterine puerperale est une complication obstetricale rare mais grave. Une mauvaise prise en charge de la troisieme phase du travail semble favoriser sa survenue. Nous en rapportons un cas observe chez une primipare de 19 ans ayant accouche a domicile avec delivrance hemorragique. Une reduction chirurgicale par voie basse etait pratiquee. Les particularites diagnostiques et les principes de la prise en charge sont discutes a la lumiere d'une revue de la litterature

Prolapsed uterine sarcoma causing non-puerperal uterine inversion in a post menopausal woman.

A rare case of non-puerperal uterine inversion caused by a large fundal sarcoma in a 57 year old menopausal woman who presented with profuse vaginal bleeding is reported. After vaginal excision of the fundal myoma, reduction of the uterine inversion combined approach both abdominal as well as vaginal successfully was then followed by total abdominal hysterectomy and bilateral salphingoopherectomy.

Chronic non puerperal inversion of uterus

Inversion of the uterus is a rare clinical problem. It occurs either as an obstetric emergency or as a gynecological complication where it is a diagnostic challenge. A rare case of non- puerperal inversion, caused by fundal leiomyoma, was encountered in a-59- year old woman resulting in severe vaginal bleeding. It was thought initially to be a large pedunculated fibroid polyp, but it was discovered to be associated with inversion during surgery. She was treated with total hysterectomy using an abdominal and vaginal approach

Puerperal uterine inversion, a case report

Acute puerperal uterine inversion is a rare but life threatening complication in which the uterine fundus collapses within the endometrial cavity. The rate of uterine inversion is estimated from one in 2000 to one in several hundred thousand labors. Although the cause of uterine inversion is unclear, several predisposing factors have been described. Maternal mortality is extremely high unless the condition is immediately recognized and corrected. The patient was a pregnant woman [G [2] P [1], 27 years old, admitted in Yasuj Imam Sadjad Hospital due to onset of labor pains. The patient had history of cesarean section in first pregnancy and the indication of cesarean was unclear. She wanted to have vaginal delivery. Delivery was taken normally. Placenta exited the vagina together with dark-red mass attached to it. Placenta was detached simply from the mass. The mass did not have massive bleeding. With diagnosis of uterine inversion manual correction of inversion was begun. The inversion was converted from complete to incomplete inversion. The correction was not completely successful. The patient's condition was poor and went to shock. Because of these reasons the patient underwent manual reinsertion of the uterus under general anesthesia and then was prepared for surgical correction. Although the uterine inversion is not very common, it will result in severe hemorrhage and shock, if left unrecognized, and leads to maternal death

Non-puerperal uterine inversion -a case report

Inversion of the uterus is a rare clinical problem. It is encountered as an obstetric emergency and a diagnostic challenge in gynecology. Non-puerperal inversion usually results from a tumor implanted on fundus of the uterus. Treatment depends on the associated pathology and the stage. A rare case of non-puerperal uterine inversion caused by a large fundal leiomyoma was reported in Bahounar Hospital, Kerman, in a 38 years old woman resulting in severe lower abdominal pain and profuse vaginal bleeding. After incomplete myomectomy, reduce the inversion vaginally was successful and abdominal hysterectomy was performed