Puerperal uterine inversion
- John T Repke, MD
John T Repke, MD
- ACOG Peer Reviewer
- Professor 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 cavityTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS