K. Srinivas1, K. V. Malini2, Rajeshwari B. K3, Smrithi Cheluvaraj4
ABSTRACT: Acute uterine inversion is a rare and life-threatening post-partum complication which often occurs when the placenta fails to detach from the uterus after childbirth. The uterine fundus falls into the endometrial cavity and may descend to the cervix (incomplete) or beyond the cervix (complete). Death may occur in 15% of the affected mothers due to blood loss and shock. AIM: To study case profiles of women who present with acute uterine inversion and to the maternal outcome and the determinants of the outcome in these cases. METHODOLOGY: It is a retrospective study for a period of 84 months at Vanivilas hospital attached to Bangalore Medical College from. 14 women in whom inversion was diagnosed were identified from the records. Maternal complications PPH, retained placenta, need for hysterectomy, ICU admissions, death were noted. Co morbid conditions which worsened the prognosis were looked into. RESULTS: 100% of the patients were booked elsewhere. Only 5 of them delivered in our hospital rest delivered elsewhere and were referred. 6 were primigravidae, 8 of them were in the age group of 20-25 years. Inversions were noticed in our hospital during caesarean with no adverse outcomes. 10 had delivered vaginally of which 9 were referred from elsewhere. Deliveries were conducted by obstetricians or trained personnel in 8 cases out of which 9 referred cases and 1 case was a home delivery conducted by an untrained dai. 4 patients required hysterectomy, 4 cases were diagnosed and managed corrected was made during caesarean section. Immediately and the rest 6 cases it was manually reduced. 2 women succumbed to PPH and shock. CONCLUSION: Acute uterine inversion a very rare complication after delivery but may be life threatening. Prompt immediate reposition could save the mother from neurogenic or haemorrhagic shock. Co morbid conditions may worsen the morbidity.
