A case report of uterine inversion after home delivery

Abstract

Puerperal acute uterine inversion is a rare obstetric condition observed as a serious complication during the third stage of labor. Reported as one of the causes of postpartum haemorrhage, it commonly requires quick diagnosis and surgical treatment in order to reduce morbidity and lethality. The authors describe a case of uterine inversion with hypovolemic shock after home birth, brought to Hospital Leonor Mendes de Barros. The purpose of this article is to describe a case of acute uterine inversion and its management and a review of aetiology, predictive and risk factors, diagnosis and treatment.

Uterine inversion in retained placenta, that’s why a good management of third stage of labor matters: A case report

“… 13 Uterus reversal can be performed called Johnson’s maneuver wherein manual pressure is applied on the fundus through the cervix in the direction of the long axis of vagina using palm of the hand. 3 , 6 , 12 This procedure should be performed promptly to minimize blood loss and enhance the likelihood of successful resolution, as delaying the maneuver reduces the success rate. This reduction of success rate is due to the involution of the cervix, which induces a rigid ring that makes restoration of normal uterus position difficult.…”

“… 5 There are several therapeutic strategies describe in the literature including drugs, manual maneuvers called Johnson’s Maneuver and surgical intervention. 1 , 3 , 6 , 7 …”

Post-partum complete acute uterine inversion: A coordinated multi-disciplinary approach ameliorates an obstetric nightmare, a case report

“…[ 4 6 7 8 9 11 ] The clinical diagnosis usually includes the triad: haemorrhage, shock and pelvic pain and any health care provider performing delivery even at primary health centres must keep this in mind. [ 2 ] Sudden onset of significant vaginal bleeding, severe abdominal pain with strong bearing down sensation after delivery should alert them to possible uterine inversion. [ 9 11 12 ] The absence of uterine fundus on abdominal palpation and its presence in the vagina is pathognomic.…”

“…[ 1 ] It commonly presents as triad of haemorrhage, shock and pelvic pain. [ 2 ] A high index of clinical suspicion by primary physician or even by a qualified team of paramedics with knowledge of the third stage of labour is paramount for diagnosis. [ 2 3 4 5 6 7 ] The aim of this case report is to reiterate the occurrence of acute uterine inversion after active management of third stage of labour.…”

“…[ 2 ] A high index of clinical suspicion by primary physician or even by a qualified team of paramedics with knowledge of the third stage of labour is paramount for diagnosis. [ 2 3 4 5 6 7 ] The aim of this case report is to reiterate the occurrence of acute uterine inversion after active management of third stage of labour. Undoubtedly, rapid diagnosis and a multidisciplinary approach plays a big role in preventing maternal mortality.…”