Use of Intrauterine Ballon Temponade in Treatment of Acute Uterine Inversion after Reinversion done by Huntingtons Method

Abstract

Uterine inversion following delivery though rare yet very serious and life threatening complication of labour much attributed to mismanagement of third stage of labour. Its incidence varies from1  in 2000 to 1 in 50,000 deliveries. This variation in incidence is due to variation in reporting and management option at different setups. The incidence is higher  in deliveries conducted by untrained birth attendants usually at home and improper management of third stage of labour. This rare complication of labour is associated with severe post partum hemorrhage and shock resulting in  maternal death in 10-15%.  Commonest  cause is mismanagement of third stage of labour. Uterine inversion is diagnosed clinically by massive bleeding, shock and strong pelvic pain.

A 20 year old female presented to the emergency department with history of massive per vaginal bleeding following vaginal delivery at home by a Dai. On receiving patient was having pulse rate of 122 bpm, BPP was 80/50.patient was tachypnic cold and very pale and had urinary retention for many hours. Patient was examined after resusitation. On abdominal examination uterine fundus was not palpable. On bimanual examination a bulge was felt in vagina  that was fleshy and bleeding on touch with no cervical os palpable.