Uterine inversion: a shocking aftermath of mismanaged third stage of labour

Background: To study the incidence, causes, clinical presentations, management and maternal morbidity and mortality associated with acute puerperal inversion of uterus. Methods: This retrospective study was conducted in Department of Obstetrics and Gynecology, G.S.V.M. Medical College, Kanpur, from March 2008 to March 2013. All the women who developed acute puerperal inversion of uterus either in or outside our hospital were included in the study. Results: Majority of women presenting with inversion belonged to age group 20-35 years, were multigravida (68.2%), came from rural set-up (81.4%) and were unbooked (81.8%). Majority of deliveries complicated by inversion took place at home (50%), delivered by dais (46%). Mismanaged 3rd stage of labour proved to be an important factor (36.4%) leading to inversion uterus followed by atonicity of uterus. 90% of women suffered due to delay in management at PHC and CHC, 68%women succumbed to delay in diagnosis at the place of delivery by untrained staff, whereas 45% women suffered due to delay in transport facility. 13.63% women suffered from sepsis in post-operative period, 22.72% from renal failure whereas 18.18% died. Conclusion: Proper education and training regarding active management of third stage of labour, diagnosis and management of uterine inversion should be imparted to traditional birth attendants, so that this potentially life-threatening obstetric emergency could be averted. [Int J Reprod Contracept Obstet Gynecol 2013; 2(3.000): 292-295]