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Abstract
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. Postpartum 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.
Résumé
Objectif : Déterminer l’incidence, les complications et le risque de récurrence de l’inversion utérine aiguë.
Méthode : On a fait une analyse rétrospective des dossiers de toutes les patientes ayant subi une inversion utérine à l’Hôpital Grace Maternity de Halifax (Nouvelle-Écosse), de 1977 à 2000.
Résultats : Pendant cette période de 24 ans, 40 cas d’inversion utérine aiguë se sont présentés, sur un total de 125 081 accouchements. L’incidence d’inversion utérine aiguë, à la suite d’une naissance vaginale, a été de 1 sur 3 737 et, à la suite d’une césarienne, de 1 sur 1 860. Parmi ces cas, 65 % ont été compliqués par une hémorragie de postpartum, et on a dû faire une transfusion de sang dans 47,5 % des cas. Il n’y a pas eu de récurrence lors des 26 accouchements ultérieurs. Après la mise en place d’une politique de prise en charge active du troisième stade du travail, en 1988, l’incidence des inversions utérines aiguës après un accouchement vaginal a été 4,4 fois plus basse.
Conclusion : L’inversion utérine aiguë est rare, mais elle s’accompagne d’un risque élevé d’hémorragie de postpartum et de la nécessité de faire une transfusion de sang. Une prise en charge active du troisième stade du travail pourrait en réduire l’incidence.
Key words
References
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Article info
Publication history
Accepted:
July 2,
2002
Received in revised form:
July 2,
2002
Received:
May 21,
2002
Identification
Copyright
© 2002 Published by Elsevier Inc.
