Acute puerperal uterine inversion a rare but life threatening complication of the third stage of labour.

ABSTRACT

To find out the causes of acute puerperal inversion in the study population so that appropriate preventive measures could be planned. This presentation is based on two studies conducted at two teaching maternity units in Lahore. Duration of the first study was from July 1985 to December 1990 and second one extended from January 1991 to June 1996. Demographic data, details of index labour and placental delivery were collected. An effort was made to determine the cause of inversion. Ten cases of acute uterine inversion were seen among 34293 deliveries during the said period, prevalence was prevalence was 1 in 3429 deliveries. Parity of the parturients ranged from 2-6. Haemorrhage and shock were the commonest presenting features. Six women were delivered by the TBAs. Injudicious traction on the umbilical cord in the presence of a lax uterus was probably the most likely underlying cause. Complete uterine inversion occurred in 6 patients. Nine cases were managed by manual reduction and one required surgical intervention. Three had hysterectomy due to uncontrolled bleeding due to uterine atony after correction. Proper education and training regarding placental delivery must be imparted to the care providers engaged at different levels in maternity healthcare system so as to avoid this fatal but preventable obstetric emergency