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Puerperal uterine inversion

John T Repke, MD
Section Editor
Vincenzo Berghella, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


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 [1]. 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:

Extent of inversion (figure 1) [6]:

1st degree (incomplete) inversion: the fundus is within the endometrial cavity

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Literature review current through: Nov 2017. | This topic last updated: Sep 25, 2017.
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