ABSTRACT
Uterine inversion is a life-threatening medical emergency, which can result in fatal shock and sudden unexpected death during and after delivery. Most cases of uterine inversion occur due to mismanagement of the third stage of labour. We report a case of sudden death occurring post full-term vaginal delivery conducted by a traditional birth attendant (TBA) popularly known as dai. Autopsy revealed signs of haemorrhage and shock due to an inverted uterus. This emergency medical condition, though frequently fatal, can be treated if prompt action is taken by a trained and skilled obstetrician, preventing morbidity and mortality. We discuss the incidence, aetiology, symptomatology, complications and the management of uterine inversion. We also review the capability and eligibility of TBAs in handling such obstetrical emergencies, along with their culpability, if any, in such cases of negligence as per the applicable statutes.
Subject(s)
Delivery, Obstetric/adverse effects , Malpractice/legislation & jurisprudence , Midwifery/legislation & jurisprudence , Uterine Inversion/etiology , Adult , Fatal Outcome , Female , Humans , India , Postpartum Hemorrhage , Pregnancy , Shock, Hemorrhagic/etiologyABSTRACT
A inversão uterina é uma patologia rara, ocorre comocomplicação grave do terceiro estágio do trabalho departo. O aspecto mais importante reside no diagnósticoprecoce e como consequência uma conduta terapêuticametódica e urgente; quanto maior o atraso no tratamentomais alto a taxa de mortalidade. Descreve-se um casode inversão uterina não responsiva ao tratamento mesmosem apresentar intercorrências desde o pré-natalaté o parto. As autoras abordam em seguida os fatoresetiológicos, o diagnóstico e a terapêutica.
The uterus inversion is a rare pathology, occurs as aserious complication of the third labor stage. The mainlyaspect is an early diagnosis and consequently an therapeuticmethodical and urgent conduct; as longer isthe delay in treatment, as highest is the mortality rate.A case of uterine inversion that was unresponsive tothe treatment even without presenting complicationsfrom prenatal until delivery is described. The authorsthen discuss the etiologic factors, the diagnosis and thetherapeutic.
