Sonographic findings in acute uterine inversion

Abstract

We present a case of acute uterine inversion in the third stage of labor in which critical management decisions were facilitated by ultrasound imaging in the operating room. Identification of the ovary and adnexa pulled into the indentation of the inversion allowed the successful diagnosis and guidance for uterine replacement.

A Rare Case of Chronic Uterine Inversion Secondary to Submucosal Fibroid Managed in the Province Hospital of Nepal

“…The ultrasonographic examination should include sagittal images across the entire uterus with proper cephalocaudal orientation since images that are not oriented correctly may be misleading and could give the false impression of the normal anatomic position of the uterus. The ultrasonographic finding includes an indentation of the cephalad portion of the uterus with a hypoechoic structure (ovary) on top that seemed to be protruding from the indentation [8]. In our case, multiple attempts of ultrasound were done including in the operation theatre until we could conclude for uterine inversion.…”

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

“…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.…”

“…[3] Ultrasound is also helpful in confirming the appropriate replacement of the uterus to its normal anatomic position. [14] Early recognition and timely intervention to promptly replace the inverted uterus is critical in preventing maternal morbidity and mortality associated with uterine inversion. Maternal mortality, usually from haemorrhage and shock, can complicate up to 15% of cases.…”