Puerperal uterine inversion: risk factors, diagnosis, obstetric tactics

Tskhay V.B., Kostareva O.V.

1) Department of Perinatology, Obstetrics, and Gynecology, Faculty of General Medicine, Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, Krasnoyarsk, Russia; 2) Federal Siberian Research Clinical Center, Federal Biomedical Agency of Russia, Krasnoyarsk, Russia
Uterine inversion is a puerperal complication, the incidence of which ranges from 1:1700 to 1:20 000, according to some reports. This complication is frequently accompanied by postpartum hemorrhage and hypovolemic shock, which, if not properly managed, can cause hysterectomy and even maternal death. This is a situation that is exigent and needs emergency obstetric care. Surgical treatment requires rapid recognition, intensive care, and immediate uterine repositioning either manually or surgically. An analysis of the data available in the literature, as well as the results of previous studies have shown that there is a need to develop Russian clinical practice guidelines on the organization of emergency care for puerperas with uterine inversion, the introduction of which will be able to facilitate the decision-making process when choosing obstetric tactics, as well as to reduce the frequency of surgical interventions, hysterectomies, and maternal complications.
Conclusion: Puerperal uterine inversion can lead to massive blood loss and even cause maternal death. The inverted uterus should be repositioned as soon as possible, therefore, it is important to quickly implement treatment and diagnostic measures and to commit the practiced team actions of obstetricians//gynecologists and anesthesiologists, as well as midwives and operating nurses. Each obstetrician/gynecologist should be able to diagnose this rare but severe puerperal complication and to eliminate it in a timely manner.


uterine inversion
postpartum hemorrhage
manual and surgical uterine repositioning


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Received 12.08.2022

Accepted 25.11.2022

About the Authors

Vitaly B. Tskhay, Dr. Med. Sci., Professor, Head of the Department of Perinatology, Obstetrics and Gynecology, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia; Scientific Supervisor of Obstetrics and Gynecology, Federal Siberian Scientific and Clinical Center of the FMBA of Russia,
+7(923)287-21-34, tchai@yandex.ru, 660022, Russia, Krasnoyarsk, P. Zheleznyaka str., 1.
Olga V. Kostareva, PhD, Associate Professor at the Department of Perinatology, Obstetrics and Gynecology, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Ministry of Health of Russia, +7(913)590-72-90, olgakostar@yandex.ru, 660022, Russia, Krasnoyarsk, P. Zheleznyaka str., 1.

Authors’ contributions: Tskhay V.B. – development of the design of the investigation, review of publications on the topic of the article, peer-review of the manuscript; Kostareva O.V. – review of publications on the topic of the article, writing the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Tskhay V.B., Kostareva O.V.
Puerperal uterine inversion: risk factors, diagnosis, obstetric tactics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 12: 26-32 (in Russian)

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