Puerperal uterine inversion, a case report

ABSTRACT

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