Uterine inversion

Source: Wikipedia, the free encyclopedia.
Uterine inversion
antibiotics[1]
Prognosis~15% risk of death[3]
FrequencyAbout 1 in 6,000 deliveries[1][4]

Uterine inversion is when the

low blood pressure.[1] Rarely inversion may occur not in association with pregnancy.[5]

Risk factors include pulling on the

connective tissue disorders.[1] Diagnosis is by seeing the inside of the uterus either in or coming out of the vagina.[2][6]

Treatment involves standard

antibiotics are typically recommended.[1] The placenta can then be removed if it is still attached.[1]

Uterine inversion occurs in about 1 in 2,000 to 1 in 10,000 deliveries.

developing world.[1] The risk of death of the mother is about 15% while historically it has been as high as 80%.[3][1] The condition has been described since at least 300 BC by Hippocrates.[1]

Signs and symptoms

Drawing of an inverted uterus

Uterine inversion is often associated with significant

parasympathetic effect of traction on the uterine ligaments may cause bradycardia
.

Causes

The most common cause is the mismanagement of 3rd stage of labor, such as:

  • Fundal pressure
  • Excess cord traction during the 3rd stage of labor

Other natural causes can be:

  • Uterine weakness, congenital or not
  • Precipitate delivery
  • Short umbilical cord

It is more common in multiple gestation than in singleton pregnancies.

Associations

  • Placenta praevia
  • Fundal Placental Implantation
  • Use of
    Magnesium Sulfate
  • Vigorous fundal pressure
  • Repeated cord traction
  • short umbilical cord

Types

Incomplete (left) and complete (right) inversion of the uterus
  • One: Complete. Visible outside the cervix.
  • Two: Incomplete. Visible only at the cervix.[7]

Treatment

Manual replacement of the uterus

Treatment involves standard

antibiotics are typically recommended.[1] The placenta can then be removed if it is still attached.[1]

Epidemiology

Uterine inversion occurs in about 1 in 2,000 to 1 in 10,000 deliveries.

References