scholarly journals Total Uterine Inversion After Normal Vaginal Delivery: A Case Report

2021 ◽  
Author(s):  
Ladan Kashani ◽  
Afsaneh Tehranian ◽  
Shima Mohiti ◽  
Ladan Hosseini
Keyword(s):  
Vaginal Delivery ◽  
Valsalva Maneuver ◽  
Abdominal Hysterectomy ◽  
Pathological Examination ◽  
Normal Vaginal Delivery ◽  
Uterine Inversion ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
History Of ◽  
Abnormal Vaginal Bleeding

Puerperal uterine inversion is a rare obstetric emergency that may cause maternal mortality. We describe a multiparous woman with total uterine inversion after a normal vaginal delivery. A 28-years-old, gravid 3, pregnant woman was admitted to the hospital in the first stage of labor. She had a past medical history of curettage due to abnormal vaginal bleeding following her second vaginal delivery and the present pregnancy proceeded without complications. After the delivery, due to the history of placental adhesion, umbilical cord traction was avoided and after 20 min, the patient was asked to push hard. During a Valsalva maneuver, the uterus and the placenta were suddenly expelled from the vagina. The placenta was completely adherent to the decidua and the patient displayed no signs of shock. Then manual repositioning of the uterus was performed by a closed fist and a subtotal abdominal hysterectomy was performed. Pathological examination revealed placenta accreta and the placenta was found completely adherent at the fundus. Uterine inversion usually occurs unexpectedly and is unpreventable in some cases. Assessment of the possible risk factors before delivery may help predict its occurrence. Therefore, in women with a positive history, special measures should be taken in the third stage of labor to manage the possibility of inversion.

scholarly journals Evaluation of complications during third stage of labour among women delivering at tertiary care center

2018 ◽  
Vol 7 (7) ◽  
pp. 2706
Author(s):  
Tanya Agrawal ◽  
Ruchi Kalra ◽  
Aabha Suryavanshi
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Active Management ◽  
Perineal Tear ◽  
Retained Placenta ◽  
Uterine Inversion ◽  
Perineal Tears ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Maternal Morbidity And Mortality

Background: The common complications occurring during third stage of labor are PPH Retained Placenta, Morbid adherent placenta- placenta accreta, placenta increta, percreta, perineal tears, uterine inversion increasing the maternal morbidity and mortality. The objective of the present study was to evaluate percentage and spectrum of obstetrics complication occurring during third stage of labor.Methods: An observational study was done at Department of Obstetrics and Gynecology, People’s College of Medical Sciences and Research Center, Bhopal from January 2016 to December 2017. All women delivering vaginally including instrumental deliveries were included. The medio-lateral episiotomy was given to all primigravida and for multigravida decision was case based as big size babies, instrumental deliveries, rigid perineum. Active management of third stage of labor was practiced.Results: 899 women delivered vaginally during the study period of 2 years (Jan -Dec 2016 Jan -Dec 2017). Among these 6.45% (58 women) had various complications during third stage of labor . 55% were primigravida. Complications which were observed to occur during third stage of labor were perineal tear 4% (37/899 deliveries). Atonic PPH occurred in 0.5% (9/899 deliveries) Traumatic PPH was in 1.44% (13/899 deliveries and 0.3% cases had retained placenta. Associated condition in perineal tear cases were 92% had big size babies 5% cases were preterm labor and in 3% cases ventouse application was done.Conclusions: Common complications were 1st and 2nd degree perineal tears occurred in 4% deliveries and traumatic PPH were in 1.44% of cases.

scholarly journals Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Unsafe Abortion ◽  
Axillary Temperature ◽  
Uterine Inversion ◽  
History Of ◽  
Failed Surgery

Abstract Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

Association of the Length of the Third Stage of Labor and Blood Loss Following Vaginal Delivery

2018 ◽  
Vol 111 (3) ◽  
pp. 178-182 ◽  
Author(s):  
Nader Z. Rabie ◽  
Songthip Ounpraseuth ◽  
Dawn Hughes ◽  
Patrick Lang ◽  
Micah Wiegel ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage

scholarly journals Clinical Presentation and Conservative Management of Tympanic Membrane Perforation during Intrapartum Valsalva Maneuver

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Jonathan D. Baum ◽  
Meghan I. Rattigan ◽  
Eric Scott Sills ◽  
Anthony P. H. Walsh
Keyword(s):  
Tympanic Membrane ◽  
Vaginal Delivery ◽  
Valsalva Maneuver ◽  
Tympanic Membrane Perforation ◽  
Normal Vaginal Delivery ◽  
Intraabdominal Pressure ◽  
Ear Canal ◽  
Membrane Rupture ◽  
Active Labor ◽  
Membrane Perforation

Background.Tympanic membrane perforation may occur when ear pressures are excessive, including valsalva maneuver associated with active labor and vaginal delivery. A pressure differential across the eardrum of about 5 psi can cause rupture; the increased intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level.Material and Method.We describe a healthy 21-year old nulliparous patient admitted in active labor at 39-weeks' gestational age.Results.Blood appeared asymptomatically in the left ear canal at delivery during active, closed-glottis pushing. Otoscopic examination confirmed perforation of the left tympanic membrane. Complete resolution of the eardrum rupture was noted at postpartum check-up six weeks later.Conclusion.While the precise incidence of intrapartum tympanic membrane rupture is not known, it may be unrecognized without gross blood in the ear canal or subjective hearing loss following delivery. Only one prior published report on tympanic membrane perforation during delivery currently appears in the medical literature; this is the first English language description of the event. Since a vigorous and repetitive valsalva effort is common in normal vaginal delivery, clinicians should be aware of the potential for otic complications associated with the increased intraabdominal pressure characteristic of this technique.

scholarly journals On the history of management of the third stage of labor in Kazan (to the 155th anniversary of the birth of Professor V.S. Gruzdev)

2021 ◽  
Vol 102 (2) ◽  
pp. 249-257
Author(s):  
L A Kozlov
Keyword(s):  
High Efficiency ◽  
Historical Study ◽  
Manual Removal ◽  
The Third ◽  
Obstetrics And Gynaecology ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Primary Literature ◽  
History Of ◽  
Speed Up

The article aims to show the experience of the Kazan Obstetrics and Gynaecology Clinic named after V.S. Gruzdev for replacing the obstetric operation manual removal of the placenta with other techniques to prevent serious postpartum complications. Research methods the historical study of primary literature sources. Manual removal of the placenta always associated with the risk of infection and developing puerperal sepsis. That is why obstetricians are constantly looking for a replacement for this operation. In 1895, even in the pre-Kazan period of work, professor Gruzdev successfully performed a method of inserting saline into the umbilical vessels to speed-up placental separation in the third stage of labor. While working in Kazan, on his proposal, doctor L.S. Sidorova (1936), and then Professor P.V. Manenkov (1942, 1948, 1955) and doctor M.V. Korotkova (1958) thoroughly studied and implemented the method of Budimilich in the work of the maternity ward of the clinic. This method involves replacing the saline solution with the crude alum solution. The second measure, preventing hemorrhage in the third stage of labor and avoiding manual removal of the placenta, was the successfully testing intravenous pituitrin (oxytocin) injection by Z.N. Yakubova, completed with the defense of her doctoral dissertation (1962). The high efficiency of these methods allowed us to recommend to them for widespread obstetric practice.

Carbetocin versus syntometrine in the management of third stage of labor following vaginal delivery

2011 ◽  
Vol 284 (6) ◽  
pp. 1359-1365 ◽  
Author(s):  
Alsaeed A. Askar ◽  
Mohamed Taha Ismail ◽  
Amro Abo El-Ezz ◽  
Noha H. Rabie
Keyword(s):  
Vaginal Delivery ◽  
Third Stage Of Labor ◽  
Third Stage

scholarly journals Clinical study of Rh-isoimmunization in pregnant women

2018 ◽  
Vol 7 (2) ◽  
pp. 731
Author(s):  
Bhavani Bhagat ◽  
V. Sitalakshmi ◽  
K. L. Azad ◽  
Nirmala Banoth
Keyword(s):  
Vaginal Delivery ◽  
Antenatal Clinic ◽  
Fetal Outcome ◽  
Cross Sectional Study ◽  
Full Term ◽  
Normal Vaginal Delivery ◽  
Maternal Circulation ◽  
Cross Sectional ◽  
Institutional Ethics ◽  
History Of

Background: Iso-immunization has been defined as the process whereby immune antibodies are produced in an individual in response to antigens from another individual of same species. Objective was to study the fetal outcome in immunized and non-immunized women and also to prevent isoimmunization during pregnancy and labour.Methods: A total of 40 patients attending outdoor antenatal clinic or admitted in the indoor wards in obstetric unit of Obstetrics and Gynecology department were included in the present study which was hospital based cross sectional study. The study was carried out for one year at Government Medical College Jagdalpur, Chhattisgarh, India. Permission from Institutional Ethics Committee was obtained. From each and every patient included in the study, initially informed individual consent was taken.Results: Maximum patients (25%) had an income of Rs. 200- 300 per month and minimum patients (10%) had an income of Rs. 500- 600 per month. Maximum cases of Rh – negative patients 87.5% are Hindus and 10 % are Muslims while only 2.5% are Christians. The percentage of patients below 20 years is 2.5, that between 20 to 25 are 67.5, between 26 to 30 is 27.5 and between 31 to 35 is 2.5. Thus, maximum patients belong to the age group 20 to 25 years and above 31 years.. Accordingly, 6 patients had history of abortion, 2 had pre- term deliveries, and 18 had full term deliveries. 4 had history of operation and 1 had history of jaundice in previous children. Cases with presence of Rh- Antibody in Maternal Circulation during Pregnancy. It was found that one out of 40 patients, had Rh- Antibody in titer of 1: 128 and 39 cases, did not show presence of Rh- Antibody in their circulation. Outcome of pregnancy in 40 patients studied. 3 patients had pre- mature labour, 26 had normal vaginal delivery, 10 had caesarean section and one patient was Ante- natal.Conclusions: Present study reveals more than Maximum patients were from low socioeconomic group and minimum cases were from higher socio- economic group. Majority of cases were Hindus, next in order Muslims and then Christians. Age of maximum patients ranged from 20-25 years. Maximum patients had normal full term deliveries. In 65% cases, outcome of pregnancy was normal vaginal delivery.

scholarly journals An evaluation of the prevalence, cause and risk factors associated with leucorrhoea in reproductive age group women

2021 ◽  
Vol 10 (4) ◽  
pp. 1520
Author(s):  
A. Priya Arthy ◽  
Sangeeta Sen ◽  
A. Ganesh Kumar ◽  
R. Rajaram ◽  
G. Archunan
Keyword(s):  
Risk Factors ◽  
Vaginal Delivery ◽  
Vaginal Discharge ◽  
Reproductive Age ◽  
Normal Vaginal Delivery ◽  
Age Group ◽  
Barrier Methods ◽  
Obstetric History ◽  
History Of ◽  
Reproductive Age Group

Background: The community based study was carried out in women of reproductive age group with a specific aim to evaluate the prevalence and risk factors of leucorrhoea.Methods: In this investigation, a total of 191 women who presented with gynaecological complaint of white discharge and seeking medical assistance was taken as a study sample for PAP smear. The basic details like socio demographic, past obstetric history and menstrual history were included prior to the smear study.Results: High prevalence of vaginal discharge was observed in the age group of 30-39, those who had two parity, previous obstetric history of normal vaginal delivery and usage of Copper T as a method of contraception. The binary logistics model explains the risk factors levels of abnormal vaginal discharge with 95% confident interval. Based on the data analysed, the age group of 30-39 and 40-49 are more likely to have a risk of 3.22 and 2.68 folds respectively. Likewise, the participants with the history of diabetes had a 2.08 folds increased risk of leucorrhoea rather than other complications and 2.21 folds of risk to those who used barrier methods like condom as a contraceptive method.Conclusions: The results concluded that the occurrence of vaginal discharge in women is age dependent and the most common risk factors for causing the vaginal discharge in the reproductive age group i.e. 30-49 years of age, are previous normal vaginal delivery, diabetes and usage of contraceptive methods like intra uterine contraceptive device and barrier methods.

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