Acute uterine inversion: a review of 40 cases.

OBJECTIVE: To determine the incidence, complications, and risk of recurrence of acute uterine inversion.

METHODS: A retrospective chart review was conducted of all cases of acute uterine inversion recorded at the Grace Maternity Hospital in Halifax, Nova Scotia, from 1977 to 2000.

RESULTS: During the 24-year period studied, 40 cases of acute uterine inversion occurred following 125,081 births. The incidence of acute uterine inversion following vaginal birth was 1 in 3737, and following Caesarean section, 1 in 1860. Post-partum hemorrhage complicated 65% of cases of acute uterine inversion, and 47.5% required blood transfusion. There was no recurrence in 26 subsequent deliveries. Following the institution of active management of the third stage of labour in 1988, the incidence of acute uterine inversion following vaginal delivery fell 4.4-fold.

CONCLUSION: Acute uterine inversion is rare but accompanied by high risk of postpartum hemorrhage and the need for blood transfusion. Active management of the third stage of labour may reduce the incidence of uterine inversion.