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Chapter 18 - Acute Puerperal Uterine Inversion

from Section 4 - Postpartum Emergencies

Published online by Cambridge University Press:  06 May 2021

Edwin Chandraharan
St George's University of London
Sir Sabaratnam Arulkumaran
St George's University of London
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While 50% of cases of inversion of the uterus have no identifiable risk factors [5], mismanagement of the third stage (applying traction on the umbilical cord before contraction of the uterus and applying fundal pressure) is considered as the prime cause [3].Other recognised predisposing factors include uterine atony, fundal implantation of a morbidly adherent placenta, manual removal of the placenta, precipitate labour, a short umbilical cord, placenta praevia and connective tissue disorders (Marfan syndrome and Ehlers–Danlos syndrome) [3]. It has also been reported to follow sudden increases in intra-abdominal pressure such as coughing or, sneezing before contraction of uterine muscles, delivery of a baby with cord around the neck, giving birth in sitting or erect position, precipitated labour [4] and very rarely during caesarean section [1]. Even though individual risk factors do commonly occur, rarity of the condition indicates that these factors must act in unison to culminate in an inversion of the uterus.

Obstetric and Intrapartum Emergencies
A Practical Guide to Management
, pp. 133 - 138
Publisher: Cambridge University Press
Print publication year: 2021

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