Inversion of the uterus at caesarean section.
BACKGROUND
Inversion of the uterus through the uterine incision during caesarean section is a rare event. Therapy is usually simple and maternal morbidity is low when re-inversion of the uterus can be accomplished immediately. In cases of prolonged uterine inversion thereof, haemodynamic instability and shock, often out of proportion to the degree of blood loss, have been reported as serious sequelae.


METHODS
We describe such a case with a prolonged inversion to re-inversion interval where the patient suffered an intraoperative cardiovascular arrest during unrepositioned uterine inversion. Reposition of the uterus led to an immediate return of the patient's vital signs and improvement of her haemodynamic status.


CONCLUSIONS
The mechanisms of haemodynamic instability and the technical aspects of manual reduction of the inverted, heavily contracted uterus during caesarean section are discussed.
Rudloff
Udo
U
Department of Obstetrics and Gynaecology, Singleton Hospital, Sketty Lane, Swansea, Wales, SA2 8QA, UK.
Joels
Lisa A
LA
Marshall
Nick
N
D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D002585:Cesarean Section; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000601:surgery; D011247:Pregnancy; D019687:Uterine Inversion / Q000175:diagnosis* / Q000601:surgery