Puerperal sub-acute uterine inversion: a rare case report

Abstract

Puerperal uterine inversion is a complication of third stage of labour, which can lead to maternal morbidity and mortality due to haemorrhage shock and infection. Early cases can be managed by manual reposition of uterus but neglected or late cases of uterine inversion are managed by Haultain`s repair. Here we are presenting a case of subacute uterine inversion referred from peripheral hospital managed by Haultain’s technique.

Acute Uterine Inversion Complicating Mid-Trimester Unsafe Abortion in a Teenage Nigerian Girl

“…[9] Fundal pressure and cord traction before the signs of placental separation, while the uterus is still relaxed in the third stage of labour, predispose to uterine inversion. [1,4,5] It is associated with significant maternal mortality and morbidity including, but not limited to, postpartum…”

“…haemorrhage (PPH) with or without shock, requiring blood transfusion, disseminated intravascular coagulation and multi-organ damage complicating major PPH, hysterectomy from intractable haemorrhage, tissue necrosis and damage to the bladder or urethra, especially in resource-poor settings. [1][2][3][4][5][10][11][12][13][14][15] The reported incidence of uterine inversion varies widely between 1 in 2,000 to 1 in 50,000 deliveries, reflecting variations in the management of the third stage of labour. [1] The incidence has remarkably reduced with the advent of active management of the third stage of labour.…”

“…[1][2][3][4][5][10][11][12][13][14][15] The reported incidence of uterine inversion varies widely between 1 in 2,000 to 1 in 50,000 deliveries, reflecting variations in the management of the third stage of labour. [1] The incidence has remarkably reduced with the advent of active management of the third stage of labour. Whereas many cases of puerperal uterine inversion following vaginal or caesarean delivery have been reported, only a few cases of postabortion inversion have been documented in the literature.…”

“…The fundus of the uterus invaginates through the cervix to lie within the vagina or, less often, outside the introitus. [1][2][3][4][5] In contrast to uterovaginal prolapse, the external cervical os is not the leading point of the inverted uterus. The reported incidence of uterine inversion is about 1 in 2,000 to 1 in 50,000 deliveries.…”

“…The reported incidence of uterine inversion is about 1 in 2,000 to 1 in 50,000 deliveries. [1] It can occur in the puerperal or non-puerperal period. In the puerperium, it often complicates the third stage of labour and may lead to intractable haemorrhage and shock if adequate and prompt measures are not instituted.…”