ACUTE UTERINE INVERSION- A CASE REPORT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 50
Abstract
PRESENTATION OF CASE Puerperal inversion of uterus is a rare but well-known lifethreatening complication occurring during the 3rd stage of labour. The incidence of uterine inversion is approximately 1 in 2500 to 1 in 3700 deliveries.1,2 When not immediately identified, the massive & often underestimated blood loss can lead to hypovolemic shock & maternal death that can reach upto 15 % in some series.3 Mismanaged third stage of labour being the most common cause followed by cord traction on an abnormally adherent placenta, precipitate labour, & short umbilical cord in its aetiology.4 The diagnosis of puerperal uterine inversion is mainly clinical, based on 3 elements: haemorrhage, shock & strong pelvic pain.5 Shock results from hypovolemia which is secondary to bleeding and to vagal reaction associated to the stretching of nerve fibres in uterine ligaments.6 A 26 years old primipara was referred to Jay Kay Lon Hospital, Govt. Medical College, Kota, Rajasthan, with neurogenic shock. She had a vaginal delivery, 6 hours ago in the community health centre, Deoli (Dist. Tonk), Rajasthan and had given birth to a healthy baby. The patient was herself a staff nurse and had a history of precipitate labour. Uterus inverted soon after the delivery but was referred as a case of uterine fibroid or uterine inertia. On arrival to our hospital, patient’s general condition was poor, peripheral pulses not palpable, B.P. was not recordable. On per abdomen examination: dimpling of uterus noted, per speculum examination- 2 packs removed from the vagina, a fleshy mass seen in the vagina, same was bleeding and cervical ring felt around the prolapsed mass.
Authors and Affiliations
Nirmala Sharma, Neha Seehra, Amar Singh
Keywords
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- EP ID EP549338
- DOI 10.14260/jemds/2018/1194
- Views 88
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