DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20222336
Published: 2022-08-29

Interesting rare case of recurrent puerperal uterine inversion: a case report

Sushila Kharkwal, Divya Jain, Sippy Agarwal, Divya Pandey

Abstract


Uterine inversion is a rare obstetric emergency that may lead to severe haemorrhage, shock and eventually death. The incidence of uterine inversion varies from one in 2,000-20,000 deliveries. Recurrent uterine inversion is still rare with no exact reported incidence so far. We report a case of a near miss patient, 28 years old primiparous with complete uterine inversion with atonic postpartum haemorrhage and shock, managed by manual repositioning and tamponade insertion which got corrected. Patient had recurrent uterine inversion twice in the puerperal period on 5th and 7th postpartum day. A new approach to management was taken. Rather than going for laparotomy, vaginal manual correction followed by intrauterine tri-way foley catheter insertion was done. Gradual deflation was done leading to final permanent correction. Uterine inversion is a rare but potentially deadly complication post vaginal delivery. Mortality and morbidity can be reduced by rapid recognition and immediate replacement. For recurrent inversion prolonged intrauterine balloon placement may be needed in rare cases.


Keywords


Manual uterine re-position, Recurrent uterine inversion, Tamponade, Tri-way foley catheter, Postpartum haemorrhage, Near miss

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References


Coad SL, Dahlgren LS, Hutcheon JA. Risks and consequences of puerperal uterine inversion in the United States, 2004 through 2013. Am J Obstet Gynecol. 2017;217(3):377.

Dwivedi S, Gupta N, Mishra A, Pande S, Lal P. Uterine inversion: a shocking aftermath of mismanaged third stage of labour. Int J Reprod Contracept Obstet Gynecol. 2013;2:292.

Jalvee RG, Wani RJ. Uterine inversion - an obstetrician’s nightmare: a series of 3 cases of uterine inversion and a review of management options. Int J Reprod Contracept Obstet Gynecol. 2021;10:2050-4.

Brokenshire J, Thomas J. Uterine Inversion and Postpartum Hemorrhage. EM Cases. 2016.

Francois KE, Foley MR. Antepartum and postpartum hemorrhage. In: Gabbe SG, Niebyl JR, Simpson JL, et al. Obstetrics: Normal and Problem Pregnancies. 7th edition. Philadelphia, PA: Elsevier. 2017.

Nambisan B. Successful management of recurrent puerperal uterine inversion. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3619-21.

Soleymani Majd H, Pilsniak A, Reginald P. Recurrent uterine inversion: a novel treatment approach using SOS Bakri balloon. BJOG. 2009;116:999-1001.

Elósegui JJH, Arenas FJF, García AC, López JAL, Peinado GC, Martí JMT. Conservative management of a recurrent puerperal uterine inversion with bakri balloon tamponade. Open J Obstet Gynecol. 2011;1:197-201.

Sharma N, Ram K, Sharma A, Sharma S. A unique case of recurrent uterine inversion requiring double reposition. Int J Reprod Contracept Obstet Gynecol. 2013;2(3):427-9.

Kabir N, Islam F, Zannat F, Razzak M. Early Recurrent Inversion - A Case Report. Bangladesh J Obstet Gynaecol. 2008;23(1):35-7.