Chronic Uterine Inversion Following Mid-Trimester Abortion

Mishra, Sujnanendra

doi:10.1007/s13224-017-1040-1

Cited by 11 publications

(23 citation statements)

References 2 publications

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“…Usually patient present with vaginal bleeding, lower abdominal pain, smooth, round mass protruding from the cervix or vagina, and urinary retention. Commonly uterine inversion presents as severe postpartum haemorrhage and hypovolemic shock [2] The patient presented with protruding mass and hypovolemic shock. Diagnosis is frequently clinical as was in our case but, ultrasound examination shows abnormal uterine fundal contour with a homogeneous globular mass within the uterus.…”

Section: Discussionmentioning

confidence: 98%

“…Subacute puerperal uterine inversion occurs when the uterine fundus collapses into the endometrial cavity between 24 h to 1 month postpartum [ 1 ]. It is a rare gynaecological emergency in practice and literature [ 2 ] but potentially fatal when not diagnosed and treated fast. Uterine inversion is an unpredictable obstetric emergency that should be considered when a woman in puerperium presents with postpartum bleeding, low blood pressure, abdominal pain and a mass in the vagina.…”

Section: Introductionmentioning

confidence: 99%

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Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020

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Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020

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“…not protrude beyond the cervical ring, second degree-the corpus passes through the cervical ring but does not reach the perineum, third degree-the fundus extends to the perineum, and fourth degree-the vagina inverts along with the uterus past the perineum.¹ The incidence of uterine inversion varies from 1 in 1739 to 20,000 deliveries. 1,5 In a nationwide study from 2004 to 2013 in the United States, there were 2427 cases in 8,294,279 deliveries, corresponding to an incidence of 2.9 per 10,000 deliveries.³ It is a puerperal event, with only 150 cases of non-puerperal inversion reported in the literature from 1887 to 2006.¹ The mortality rate due to uterine inversion has decreased from 15% to zero or as low as 4.1 per 10,000. 1,3 A report of six cases of uterine inversion from Nepal described morbidity but no mortality.⁶ The etiology of uterine inversion is still not well understood.…”

Section: Casementioning

confidence: 99%

“…1,2 The uterine inversion usually occurs following delivery and only a handful of post-abortal uterine inversion cases have been reported so far. [3][4][5] Here, we report a case of post-abortal uterine inversion in a woman who presented with a mass coming out of the vagina and per vaginal bleeding. Written informed consent from the patient and ethical clearance from the institutional review committee was obtained for publishing this case report.…”

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confidence: 94%

Chronic Inversion of Uterus Following Spontaneous Abortion: A Case Report

Manandhar

Shah

Rijal

2020

JBPKIHS

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Uterine inversion is a rare entity but poses a serious threat if not diagnosed and managed timely. Here we present a case of chronic uterine inversion in a 30-year-old lady who presented in emergency with a mass coming out per vagina, blood mixed vaginal discharge, and lower pain abdomen for the last 15 days. She underwent laparotomy and was found to have uterine inversion. The patient was attempted for repositioning of uterus with the Huntington’s approach, but it was unsuccessful, hence Haultain’s operation was done with a total abdominal hysterectomy and bilateral salpingectomy with right-sided ovarian cystectomy for a dermoid cyst. Our case emphasizes the importance of keeping chronic uterine inversion as a differential diagnosis in women presenting with pain abdomen, mass, and bleeding per vagina, and with a recent history of second-trimester abortion. Timely recognition, especially in chronic inversion, will decrease the morbidity and mortality associated with this rare but life-threatening condition.

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“…The incidence varies in different populations, ranging from 1 in 3500 to 20,000 deliveries (3,4). There are only few case reports of uterine inversion after mid trimester abortion (5,6). Though it is a rare event, healthcare workers should be aware and vigilant about this condition because if not timely diagnosed and managed, it can lead to shock and even death.…”

Section: Answermentioning

confidence: 99%