A case of third degree hemorrhagic shock due to total subacute uterine inversion after delivery

  • William Timotius Wahono Puruk Cahu General Hospital, Central Kalimantan, Indonesia http://orcid.org/0000-0002-6269-6969
  • Angela Putri Puruk Cahu General Hospital, Central Kalimantan, Indonesia https://orcid.org/0000-0002-7064-6283
  • Yudianto Budi Saroyo Department of Obstetrics and Gynecology, Universitas Indonesia, Jakarta, Indonesia
  • Antonius Joko Nugroho Puruk Cahu General Hospital, Central Kalimantan, Indonesia
  • Ruth Sally Puruk Cahu General Hospital, Central Kalimantan, Indonesia
  • Sugianto Parulian Simanjuntak Puruk Cahu General Hospital, Central Kalimantan, Indonesia
  • Samuel Puruk Cahu General Hospital, Central Kalimantan, Indonesia
Keywords: postpartum hemorrhage, risk factor, uterine inversion
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Abstract

Uterine inversion is a rare, but life-threatening obstetric emergency. We describe a case of total subacute uterine inversion in settings with limited resources. A multiparous (P4) 29-year-old woman with history of delivery assisted by a traditional birth attendant who used the fundal pressure technique 4 days before admission was referred due to postpartum hemorrhage. She had low blood pressure, tachycardia, and lethargic. A protruding mass from the vaginal introitus with active bleeding was visible. She diagnosed with third degree hemorrhagic shock due to total subacute uterine inversion. Resuscitation was initiated immediately and manual uterine repositioning was performed under general anesthesia. After two failed attempts, a laparotomy was performed to apply traction to the round ligaments and an incision on the cervical ring by using Allis clamps. The inversion was resolved. Next, subtotal hysterectomy was done to stop bleeding and infection.

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Published
2021-02-11
How to Cite
1.
Wahono WT, Putri A, Saroyo YB, Nugroho AJ, Sally R, Simanjuntak SP, Samuel. A case of third degree hemorrhagic shock due to total subacute uterine inversion after delivery. Med J Indones [Internet]. 2021Feb.11 [cited 2021Jun.21];30(1):71–4. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/3862
Section
Case Report/Series