Puerperal uterine inversion
- John T Repke, MD
John T Repke, MD
- ACOG Peer Reviewer
- Professor and Chairman, Department of Obstetrics and Gynecology
- Penn State College of Medicine
- Milton S. Hershey Medical Center
Uterine inversion occurs when the uterine fundus collapses into the endometrial cavity, turning the uterus partially or completely inside out. It is a rare complication of vaginal or cesarean delivery, but when it occurs, it is a life-threatening obstetrical emergency. If not promptly recognized and treated, uterine inversion can lead to severe hemorrhage and shock, resulting in maternal death.
Spontaneous inversion of the non-puerperal uterus accounts for approximately 5 percent of all uterine inversions, and will not be addressed by this topic review . It is almost always associated with presence of a polypoid uterine tumor, usually a leiomyoma, but other tumors (eg, teratoma, sarcoma) have also been implicated [2-5].
Uterine inversions are classified by the extent of inversion and time of occurrence:
●1st degree (incomplete) inversion: the fundus is within the endometrial cavity
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- RISK FACTORS
- CLINICAL FEATURES
- Patient presentation
- Differential diagnosis
- Initial interventions
- Secondary (surgical) interventions
- Other options
- - Hydrostatic reduction
- - Vaginal surgical approaches
- Management of the placenta
- Management after correction of inversion
- RECURRENCE IN FUTURE PREGNANCY
- SUMMARY AND RECOMMENDATIONS