Puerperal uterine inversion

A 10-year retrospective study of acute puerperal inversion of the uterus was undertaken at Women and Infants Hospital of Rhode Island. There were 11 inversions in 70,481 deliveries for an incidence of one in 6407. The age ranged from 19-31 years. Seventy-three percent occurred in nulliparous women. All cases were recognized immediately, and vaginal replacement was successful in nine patients. One patient had a placenta accreta necessitating a supracervical hysterectomy, and one patient required a laparotomy and Huntington procedure for replacement. Six patients had blood loss greater than 1000 mL and three required transfusion. There were no maternal deaths.