Uterine Inversion After Home Birth A Rare Case Report and Critical Management Insights

Introduction

Uterine inversion is a life-threatening obstetric emergency rarely seen in modern clinical practiceespecially following home delivery. This case report details the medical urgency and surgical decision-making involved in a 21year-old Brazilian woman presenting with complete uterine inversion after unassisted labor. Visit https://www.obstetricgynecoljournal.com for more groundbreaking research in women’s health and emergency obstetrics.

A Rare and Rapid Emergency

• Patient Background: A 21 year old, third time pregnant woman with no prenatal care experienced labor at home.
• Emergency Response: Both mother and preterm newborn (28 weeks, 1180g) were rushed to Hospital Leonor Mendes de Barros.
• Critical Symptoms: The mother presented signs of hypovolemic shock and uterine fundus protrusion through the vaginal introitus.

Clinical Management and Surgical Intervention

• Initial Maneuver: Johnson’s maneuver attempted but failed even under anesthesia.
• Final Surgical Solution: Laparotomy revealed complete uterine inversion requiring Huntington’s procedure followed by a hysterectomy due to uterine atony.
• Post-Op Recovery: The mother received blood transfusions and ICU care, eventually stabilizing and being discharged after six days.
• Read the full study at: https://doi.org/10.29328/journal.cjog.1001086

Broader Context and Medical Implications

According to the American College of Obstetricians and Gynecologists (ACOG), uterine inversionthough raredemands swift diagnosis and multidisciplinary team coordination. The presented case reaffirms the importance of immediate response protocols and surgical readiness in emergency obstetric care.

Surgical Techniques and Preventive Strategies

• Classification of Inversion: The case fits a 3rd degree (prolapsed) acute puerperal uterine inversion.
• Surgical Approaches:
  • Huntington’s Technique: Performed but followed by hysterectomy due to uterine atony.
  • Laparoscopy vs. Laparotomy: While laparoscopy reduces trauma, laparotomy remains the gold standard in hemodynamic instability.
• Preventive Tools:
  • Bakri Balloon
  • Uterine compression sutures (Hayman, Matsubara Yano)
  • Hydrostatic reduction methods

Conclusion

Prompt multidisciplinary action can significantly influence outcomes in cases of uterine inversion. This report illustrates not only a rare occurrence but also the life saving significance of coordinated obstetric emergency careespecially in unmonitored home birth scenarios.

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