Non-puerperal uterine inversion: A case report / Philippine Journal of Obstetrics and Gynecology

ABSTRACT

Uterine inversion is a condition in which the uterus turns inside out with the fundus prolapsing to or through the cervix. Uterine inversion is classified into puerperal or nonpuerperal. Non-puerperal uterine inversion is a rare entity with no accurate estimate regarding its incidence available to date. A case of 25 year-old primipara with a one year history of abnormal uterine bleeding is presented. Her only pregnancy was 5 years prior to admission. She delivered a term baby girl of unrecalled birth weight vaginally, with no reported intrapartal or postpartum complications. Internal examination revealed a palpable mass within the middle third of the vagina measuring 4.0cm x 4.0cm x 4.0cm, doughy, with a smooth, spongy surface, seemingly prolapsed out of a smooth dilated cervix. The uterine corpus was not appreciated on bimanual examination. The patient was diagnosed to have uterine inversion and underwent conservative surgical reduction of the uterus initially with a vaginal approach using the Kustner technique which was later converted to an abdominal repair via the Haultain procedure. Non puerperal uterine inversion can be diagnosed and successfully managed in a lowresource environment, but may require the utilization of elements from several standard techniques before reduction is accomplished.