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Puerperal uterine inversion: report of nine cases
Canadian Medical Association Journal
|May 20, 1978
Summary
Acute puerperal uterine inversion is rare but preventable. Avoid fundal pressure or cord traction before uterine contraction to prevent this obstetric emergency, which requires immediate uterine replacement.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
Background:
- Acute puerperal inversion of the uterus is a rare obstetric emergency.
- The incidence was observed at one in 2176 vaginal deliveries over an 11-year period at one institution.
Observation:
- Analysis revealed no contributing factors during the first or second stages of labor.
- Six of the nine cases were linked to improper management of the third stage of labor.
Findings:
- Key contributing factors included failure to administer oxytocic agents and attempting placental expulsion before uterine contraction via fundal pressure or cord traction.
- Incomplete adherence to active management of the third stage of labor poses significant risks.
Implications:
- Immediate uterine replacement is an effective treatment for uterine inversion.
- Placental removal should not precede uterine replacement to avoid exacerbating the condition.