A cute Uterine Inversion Leading to Postpartum Bleeding: Case ReportPostpartum

A cute uterine inversion is an obstetric emergency that is a rare occurrence in the third stage of labour. The incidence of uterine inversion ranges from 1/1200 to 1/57000 deliveries. Early recognition and appropriate intervention are important as it may cause maternal mortality due to loss of blood and shock. While making a clinical diagnosis, various surgical approaches along with nonsurgical manual maneuvers are performed even if the best approach is not determined at the time of uterine inversion. We aimed to report the case of there positioning of the uterus of a multiparous patient by laparotomy following postpartum hemorrhage and atony caused by second degree uterine inversion following a vaginal delivery. A 26-year-old multiparous (G3P2) patient came to the emergency room with regular contractions in her 39 th week. She was hospitalized following examination performed as membrane intact and 4-5 cm 80% dilation were determined. She was followed up regularly due to her regular pains. She gave birth to a healthy baby girl weighing 3060 grams in five hours. The Crede maneuver had been executed once before the placenta came out, and placental separation took place within ten minutes. Following the placental separation, excessive uterine bleeding was observed. When performing bleeding control with a vaginal extractor, the patient was suspected of having myoma uteri. However, since the fundus could not be felt during the uterine massage and uterine inversion was thought to exist, manual repositioning of the uterus was performed without any success. The patient was taken to the operating room due to excessive bleeding that was reduced following laparotomy. Hysterectomy was not needed. The patient was discharged after four days with good general health. Uterine inversion is the state in which the uterine fundus reverses and extends beyond the cervix. It is not possible to foresee inversion as the factors that trigger inversion are not fully known. When uterine inversion occurs, while making a clinical diagnosis, medical treatment and various surgical approaches along with nonsurgical manual maneuvers are performed even when the best approach is not determined at the time of uterine inversion. To sum up, though uterine inversion is a rare obstetric emergency that causes postpartum bleeding, early recognition and appropriate intervention are essential to prevent poor prognosis.