Published: 2020-10-27

Uterine inversion during caesarean section: a case report

Anjaly Raj, Kallol Kumar Roy, Rinchen Zangmo, Anshu Yadav, Nilofar Noor, Sushmita Saha, Sonam Bairwa


The present report aim to sensitise the obstetrician regarding risk of uterine inversion in a scarred uterus and the importance of immediate manual replacement. Represented case is of 40 years gravida five with previous one spontaneous abortion and previous history of three ectopic pregnancies with history of open left salpingectomy for ruptured left tubal ectopic pregnancy and history of laparoscopic right tubal clipping and uterine rupture repair for cornual pregnancy underwent an emergency caesarean section at 34 weeks. Since there were no signs of placental separation, controlled cord traction of placenta was attempted and uterine inversion was noticed. Manual replacement of uterus was done followed by manual removal of the adherent placenta. There was no postpartum haemorrhage. Inversion of uterus during caesarean section is a rare obstetric complication. If unrecognized it could lead to serious morbidity due to haemorrhage and shock. Prompt diagnosis and repositioning of the uterus are important measures in management.


Uterine inversion, Caesarean section, Adherent placenta, Scarred uterus

Full Text:



Baskett TF. Acute uterine inversion: a review of 40 cases. J Obstet Gynaecol Can. 2002;24(12):953-6.

Emmott RS, Bennett A. Acute inversion of the uterus at Caesarean section. Anaesthesia 1988; 43:118-20.

Banerjee N, Deka D, Roy KK, Takkar D. Inversion of uterus during caesarean section. Eur J Obstet Gynecol Reprod Biol. 200; 91:75-7.

Vavilis D, Tsolakidis D, Athanatos D, Goutzioulis A, Bontis JN. Complete uterine inversion during caesarean section: A case report. Cases J. 2008; 1(1):127.

Rudloff U, Joels LA, Marshall N. Inversion of the uterus at caesarean section. Arch Gynecol Obstet. 2004;269(3):224-6.

Terp MR, Rasmussen KL. Uterine inversion during cesarean section. Acta Obstet Gynecol Scand. 1998; 77:788-9.

Tsivos D, Malik F, Arambage K, Hagan P, Lee C. A life threatening uterine inversion and massive postpartum haemorrhage caused by placenta accrete during Caesarean section in a primigravida: a case report. Cases J. 2009;2(1):138.

Rezende J, Barcellos JM. Inversão uterina em cesárea. Placenta accreta Uterine inversion in cesarean section. Rev Ginecol Obstet (Sao Paulo). 1965;117(1):38-45.

Khalil A, Raafat A, Calleja-Agius J, Bell R, O'Brien P. Cardiac arrest associated with uterine inversion during caesarean section. J Obstet Gynaecol. 2006; 26(7):696-7.

Studziński Z, Branicka D. Acute complete uterine inversion-care report. Ginekol Pol. 2001; 72(11): 881-4.

Masters AP. Acute inversion of the uterus at caesarean section. Anaesthesia. 1989; 44(2):167-8.

Marshall NB, Catling S. Cardiac arrest due to uterine inversion during caesarean section. Int J Obstet Anesth. 2010;19(2):231-4.

Vivanti AJ, Furet E, Nizard J. Successful use of a bakri tamponade balloon in the treatment of puerperal uterine inversion during caesarean section. J Gynecol Obstet Hum Reprod. 2017; 46(1):101-2.