Uterine inversion

Authors: L. Mužná 1;  R. Pilka 2
Authors‘ workplace: Porodnicko-gynekologické oddělení SZZ, Krnov 1;  Porodnicko-gynekologická klinika FN a LF UP, Olomouc, přednosta prof. MUDr. R. Pilka, Ph. D. 2
Published in: Čes. Gynek.2017, 82, č. 2 s. 139-144


Summarize the literature on the inversion of the uterus.

A review article.

Department of Obstetrics and Gynecology, SZZ Krnov, Department of Obstetrics and Gynecology, University Hospital, Palacky University, Olomouc.

Literature review was conducted using the following key words. There were included articles published in English since 1980, from which relevant data were obtained.

In the literature the general occurrence is broad, ranging from 1:27 000 in the UK to 1:1739 in the US, where it varies greatly according to geographic location. The uterine inversion can be generally classified according to the period from birth to diagnosis, in relation to pregnancy or by anatomical degree of prolapse. From 1887 to 2006 there were only 150 cases of uterine inversion in non puerperal women recorded. In the vast majority the incidence was observed in women older than 45 years. 85% of uterine inversion was caused by benign pathology, only 15% was associated with cancer. Treatment consists of repositioning of the uterus, to which can be used in noninvasive and invasive techniques.

Inversion of the uterus is a very serious and fortunately relatively rare complication in the third stage of labor, but also in non-puerperal women. This is the situation with high maternal morbidity and mortality rates, at which it can easily cause life-threatening hemorrhage, disseminated intravascular coagulation and the development of hemorrhagic and neurogenic shock. In most of cases there are no risk factor.

puerperal uterine inversion, non puerperal inversion of the uterus, maternal morbidity, peripartal life-threatening bleeding


1. Antonelli, E., Irion, O., Tolck, P., et al. Subacute uterine inversion: description of a novel replacement technique using the obstetric ventouse. BJOG, 2006, 113(7), p. 846–847.

2. Banerjee, N., Deka, D., Roy, KK., et al. Inversion of uterus during cesarean section. Eur J Obstet Gynecol Reprod Biol, 2000, 91(1), p. 75–77.

3. Birge, O., Tekin, B., Merdin, A., et al. Chronic total uterine inversion in a young adult patient. Am J Case Rep, 2015, 16, p. 756–759.

4. Brar, HS., Greenspoon, JS., Platt, LD., et al. Acute puerperal uterine inversion. New approaches to management. J Reprod Med, 1989, 34(2), p. 173–177.

5. Das, P. Inversion of the uterus. J Obstet Gynaecol Br Emp, 1940, 47, p. 525–548.

6. de Vries, M., Perquin, DA. Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report. J Med Case Rep, 2010, 4, p. 21.

7. Doumouchtsis, SK., Papageorghiou, AT., Arulkumaran, S. Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv, 2007, 62(8), p. 540–547.

8. Gronvall, M., Tikkanen, M., Tallberg, E., et al. Use of Bakri balloon tamponade in the treatment of postpartum hemorrhage: a series of 50 cases from a tertiary teaching hospital. Acta Obstet Gynecol Scand, 2013, 92(4), p. 433–438.

9. Haultain, FWN. The treatment of chronic uterine inversion by abdominal hysterectomy with a successful case. Br Med J, 1901, 2, p. 974.

10. Huntington, JL., Irving, FC., Kellogg, FS. Abdominal reposition in acute inversion of puerperal uterus. Am J Obstet Gynecol, 1928, 15, p. 34–40.

11. Ida, A., Ito, K., Kubota, Y., et al. Successful reduction of acute puerperal uterine inversion with the use of a Bakri postpartum balloon. Case Rep Obstet Gynecol, 2015, 2015, p. 424891.

12. Irani, S., Jordan J. Management of uterine inversion. Current Obst Gyn, 1997, 7, p. 232–235.

13. Johnson, AB. A new concept in the replacement of the inverted uterus and a report of nine cases. Am J Obstet Gynecol, 1949, 57(3), p. 557–562.

14. Kong, MC., To, WW. Balloon tamponade for postpartum hae­morrhage: case series and literature review. Hong Kong Med J, 2013, 19(6), p. 484–490.

15. Leal, RF., Luz, RM., de Almeida, JP., et al. Total and acute uterine inversion after delivery: a case report. J Med Case Rep, 2014, 8, p. 347.

16. Miller, NF. Pregnancy following inversion of the uterus. Am J Obstet Gynecol, 1927, 13, p. 307–322.

17. Minakshi, S., Shivani, A., Arshad, A. Neglected puerperal inversion of the uterus: ignorance makes acute a chronic form. Pan Afr Med J, 2012, 12, p. 89.

18. O‘Sullivan, JV. Acute inversion of the uterus. Br Med J 1945, 2(4417), p. 282–283.

19. Ogueh, O., Ayida, G. Acute uterine inversion: a new technique of hydrostatic replacement. Br J Obstet Gynaecol, 1997, 104(8), p. 951–952.

20. Pieh-Holder, KL., Bell, H., Hall, T., et al. Postpartum prolapsed leiomyoma with uterine inversion managed by vaginal hysterectomy. Case Rep Obstet Gynecol, 2014, p. 435101.

21. Platt, LD., Druzin, ML. Acute puerperal inversion of the uterus. Am J Obstet Gynecol, 1981, 141(2), p. 187–190.

22. Rocconi, R., Huh, WK., Chiang, S. Postmenopausal uterine inversion associated with endometrial polyps. Obstet Gynecol, 2003, 102(3), p. 521–523.

23. Shah-Hosseini, R., Evrard, JR. Puerperal uterine inversion. Obstet Gynecol, 1989, 73(4), p. 567–570.

24. Shivanagappa, M., Bhandiwad, A., Mahesh, M. A case of acute on chronic uterine inversion with fibroid polyp. J Clin Diagn Res, 2013, 7(11), p. 2587–2588.

25. Sinha, G., Sinha, A. Fertility and reproduction following inversion of uterus. J Indian Med Assoc, 1993, 91(6), p. 149–150.

26. Spinelli, PG. Inversion of the uterus. Riv Ginec Contemp, 1897, 11, p. 567–570.

27. Uzoma, A., Ola, B. Complete uterine inversion managed with a rusch balloon catheter. J Med Cases, 2010, 1(1), p. 8–9.

28. Vivanti, AJ., Furet, E., Nizard, J. Successful use of a Bakri Tamponade Balloon in the treatment of puerperal uterine inversion during caesarean section. J Gynecol Obstet Biol Reprod (Paris), 2016.

29. Watson, P., Besch, N., Bowes, WA., Jr. Management of acute and subacute puerperal inversion of the uterus. Obstet Gynecol, 1980, 55(1), p. 12–16.

Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine

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