Risk Factor and Management of Puerperal Uterine Inversion: A Case Series

Puerperal uterine inversion is a rare yet life-threatening obstetric emergency that may lead to severe Postpartum Hemorrhage (PPH), whereas PPH remains a leading cause of maternal mortality. Prompt diagnosis and intervention are crucial to prevent fatal outcomes. We report three cases of puerperal uterine inversion managed at a tertiary teaching hospital in Indonesia between ۲۰۲۰ and ۲۰۲۴. Risk factors identified included multiparity, prolonged labor, baby birth weight >۳۰۰۰ gr, inadequate third-stage management including aggressive cord traction, history of misoprostol use, manual placenta and uterine atony. All cases were successfully managed with manual repositioning (Johnson's method) and intrauterine condom-catheter tamponade (average blood loss ۹۸۳ mL), avoiding the need for hysterectomy. This combined non-surgical approach demonstrated high effectiveness in a low-resource setting. A critical finding was frequent misdiagnosis at primary care facilities contributed to delays in management. Strengthening birth attendant skills is crucial for preventing uterine inversion, immediate recognition and early intervention.

کلیدواژه ها:

Uterine Inversion ، Uterine Atony ، Postpartum Hemorrhage ، Obstetric Labor Complications