Manual Vaginal Reversion of Acute Puerperal Uterine Inversion: Learning by Doing.

Abstract

Uterine inversion is the folding of the fundus into the uterine cavity in varying degrees. Acute uterine inversion is a rare and unpredictable obstetric emergency. Here we report a case of a woman who had vaginal delivery complicated by postpartum hemorrhage. Diagnosed as acute puerperal uterine inversion; reposition was tried in the labor room which failed ensuing shock. Simultaneous fluid resuscitation and manual vaginal reversion under general anesthesia was done in Operation Theater, also needing blood transfusion, 5 units in total. Therefore, this case is described herein to illustrate the importance of early recognition and prompt reversion of inverted uterus vaginally,as delay can render replacement progressively more difficult and also increase the risk of hemorrhage.