Puerperal Inversion of the Uterus in Nepal: Case Reports and Review of Literature

Abstract

Retrospective study of 6 cases of puerperal inversion of the uterus is being presented from 1975 to 1995 and a review of literature for 20 years of the period 1975-1995 has been summarised. In the present series, one case with acute puerperal inversion of uterus were treated by manual reposition, 2 cases of chronic puerperal inversion of uterus was treated surgically by Kustner's vaginal approach. Two cases with subacute puerperal inversion of uterus, 1 case of chronic puerperal inversion were treated by Haultain and Huntington method. Out of 241 cases of uterine inversion obtained from review of literature for last 20 years, 229 (95%) constituted puerperal and 12 (5%) were non puerperal inversions. Among puerperal inversions, 191 (83.4%) cases were of acute type and only 6 (2.62%) cases were of subacute variety. The chronic puerperal inversion constituted 32 (13.9%). Out of 63 cases of uterine inversions in India, maternal deaths were reported as 6 (9.5%) but there was no maternal death in the present series.

Case Report - Chronic Uterine Inversion : A Rare Complication of Labour

“…[5] The prevalence of each class of inversion is 83.4%, 2.62% and 13.9% respectively. [6,7] Chronic uterine inversion due to an incomplete or uncorrected puerperal inversion may present months after the delivery as in our case. Predisposing factors towards inversion are multiparity, short cord, adherent placenta, and excessive fundal pressure during second or third stage of labour, excessive cord traction or fundal myomas.…”

Puerperal sub-acute uterine inversion: a rare case report

“…4 Puerperal uterine inversion is classified according to the delay between the delivery and the diagnosis of the uterine inversion as acute, sub-acute and chronic inversion with prevalence of 83.4%, 2.62% and 13.9% respectively. 5 The classical clinical presentations include acute uterine inversion within 24 hours of delivery, subacute uterine inversion between 24 hours to 30th day postpartum and chronic uterine inversion after more than 30 days postdelivery. The absence of uterine fundus on per abdominal palpation and inability to visualize or palpate cervix on per vaginal examination suggest uterine inversion.…”

Successful management of recurrent puerperal uterine inversion

“…This technique was originally described by Huntington. 6,7 A laparotomy is performed, and the round ligaments are identified. Following administration of a tocolytic, the surgeon applies gentle upward traction on the round ligaments.…”