Inversion of the Uterus

Schaefer, George; Veprovsky, Edward C.

doi:10.1016/s0039-6109(16)32704-9

Cited by 7 publications

(5 citation statements)

References 15 publications

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“…15 The chances of immediate repositioning are quoted as 43-88%. 11,12,16 In Johnson's description the whole hand, plus two-thirds of the forearm, is placed in the vagina. Holding the fundus in the palm and keeping the tips of the fingers at the uterocervical junction, the fundus is raised above the level of the umbilicus.…”

Section: Discussionmentioning

confidence: 99%

“…Many other risk factors have been mentioned, including uterine atony, fundal implantation of a morbidly adherent placenta, manual removal of the placenta, precipitate labour, a short umbilical cord, placenta praevia and connective tissue disorders. [4][5][6][7][8][9][10][11] It must be understood, however, that, in up to 50% of cases, no risk factors are identified and there is no mismanagement of the third stage. This condition can, therefore, be unpredictable.…”

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confidence: 99%

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Study of incidence and outcome of acute inversion of uterus

Bangal

Gagare

Bhardwaj³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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Background: Acute inversion of uterus also called as puerperal inversion of uterus is a rare, but life-threatening complication of third stage of labour. Severe uterine atony, mismanagement of third stage of labour, adherent placenta are some of the common factors associated with the occurrence of acute inversion of uterus. Early recognition and prompt treatment are important to save life of the woman.Methods: A retrospective cross-sectional record-based study was carried out to find out the incidence, presentation and outcome of cases of acute inversion of uterus admitted to Pravara Rural Hospital Loni for a period of three years (October 2015 to September 2018).Results: During the study period, there were 27,134 deliveries including 8,834 caesarean sections. There were six cases of acute inversion of uterus in the hospital during study period. The incidence of acute inversion of uterus was 0.22 per one thousand deliveries (0.27 per thousand vaginal deliveries and 0.11per one thousand caesarean sections). Three cases were referred from outside hospital and three cases had delivered at Pravara Rural Hospital. Five cases had delivered vaginally, where as one case had undergone caesarean section. There were two maternal deaths and four survivals among six cases of inversion of uterus. Severe anaemia, irreversible hypovolemic shock and multi-organ failure were causes of maternal deaths.Conclusions: Prompt recognition of uterine inversion and its immediate reposition under anaesthesia was a key for successful management. Delay in recognition and transfer of cases resulted in haemorrhagic and neurogenic shock, leading to death of a women. Institutional deliveries with practice of principles of active management of third stage of labour (AMTSL) and improvement in emergency obstetric care services at peripheral hospitals, avoiding delays at all levels will help to reduce the incidence, morbidity and mortality associated with acute inversion of uterus.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Study of incidence and outcome of acute inversion of uterus

Bangal

Gagare

Bhardwaj³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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“…This can happen when delivery is conducted by an untrained accoucheur, a situation more likely to occur in developing countries, which explains why the incidence in India is treble that of the UK. Many other risk factors have been cited, including uterine atony, fundal implantation of a morbidly adherent placenta, manual removal of the placenta, precipitate labour, a short umbilical cord, placenta praevia and connective tissue disorders (Marfan syndrome, Ehlers‐Danlos syndrome) 5,6,11–17 . It must be emphasised, however, that, in up to 50% of cases, no risk factors are identified 9 and there is no mismanagement of the third stage.…”

Section: Aetiologymentioning

confidence: 99%

“…It is thought that the passive action of uterine ligaments will rectify the uterine inversion’ 28 . The chances of immediate reduction are quoted as 43–88% 9,17,24 . In Johnson's description the whole hand, plus two‐thirds of the forearm, is placed in the vagina.…”

Section: Nonsurgical Managementmentioning

confidence: 99%

Acute inversion of the uterus

Bhalla

Wuntakal

Odejinmi

et al. 2009

The Obstetric & Gynaecologis

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Key content:• Acute uterine inversion is a rare and unpredictable obstetric emergency.• Mortality and morbidity are reduced by early recognition and management. • Shock and uterine replacement must be addressed simultaneously.• The importance of teamwork cannot be overemphasised.• There is a need for skills and drills training because of the rarity of acute inversion. Learning objectives:• To understand the pathophysiology.• To understand and to be able to evaluate critically the general management principles. Ethical issues:• Management of uterine inversion is guided by a relatively small evidence base, resulting in treatment modalities being used without proper evaluation.

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“…Many other risk factors have been mentioned, including uterine atony, fundal implantation of a morbidly adherent placenta, manual removal of the placenta, precipitate labour, a short umbilical cord, placenta praevia and connective tissue disorders. [7,8,9,10,11,12,13,14] Though, upto 50% of cases, no risk factors are identified and there is no mismanagement of the third stage. This condition can, therefore, be unpredictable.…”

Section: Introductionmentioning

confidence: 99%

Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report

Ferdausi,

Adhikary,

Rashed

et al. 2023

AIMDR

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Uterine inversion is a condition in which the interior surface of the relaxed uterus protrudes through the vaginal entrance. Its causes are divided into two categories: puerperal and non-puerperal, with puerperal uterine inversion being more common than non-puerperal uterine inversion. The most common variety is acute inversion, which occurs immediately or within 24 hours after delivery. Chronic Uterine Inversions (CUI) that occur more than four weeks after delivery are uncommon. In this study we discuss a case of a 30-year-old woman who came with the complaints of feeling of a mass in the vagina after her last confinement which was gradually coming down through the vagina and remain outside the introitus for 5 years. Based on clinical and sonographic evaluation, she was diagnosed with CUI and developed post partum haemorrhage. We adopted Haultain’s method for correction of CUI. Since, CUI as a painless vaginal mass in the delayed post-partum period is uncommon and hence documented.

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Inversion of the Uterus

Cited by 7 publications

References 15 publications

Study of incidence and outcome of acute inversion of uterus

Study of incidence and outcome of acute inversion of uterus

Acute inversion of the uterus

Successful Outcome of a Rare Complication of Vaginal Birth: A Case Report

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