Introduction: Uterine inversion is a reversal of the uterus into a glove. It is an obstetric complication of deliverance. Uterine inversion out from pregnancy is rare. The Müller duct is an embryonic tubular form...Introduction: Uterine inversion is a reversal of the uterus into a glove. It is an obstetric complication of deliverance. Uterine inversion out from pregnancy is rare. The Müller duct is an embryonic tubular formation which will transform into the vagina, uterus, and fallopian tubes. The mixed Müllerian malignant tumor is a rare tumor to girl and woman in genital activity, which develops in the uterus at the expense of vestige of the Müller channels. The association of these two pathologies is rare. We report an observation of complicated uterine inversion mulloblastoma to a teenager. Observation: A teenager of 15 years old, admitted for a vulvar tumor, which has occurred about two months. Student in the first class of senior high school, she has no medical history, and no particular surgery. She had her threat at the age of 13, and has a regular menstrual cycle of 30 days, with 05 days of period. Two months before her admission, the patient noticed during her menstruation, the perception of soft intravaginal tissue but which disappeared when her period stopped. A week before her admission, she felt pelvic pain with expulsive colic, radiating to the external genitals, 3 days later, a protusion from the vaginal vestibule of a mass, so the volume gradually increased. It is in front of this situation that the patient consults a health center, which refers her to us for treatment. On admission, the patient was conscious with a good hemodynamic state. Vulva inspection revealed a large, rounded mass with an endovaginal implantation, with necrosis areas. This mass was resistant, bleeding in any manipulation, mobile, perceive neither the cervical relief nor the presence of the uterus. The ultrasound assessment had marked: a large abdomino-pelvic pseudo-mass with urinary repercussions right form of hydronephrosis uretero and associated with gastric distension, and MRI complete inversion of the uterus, with the uterine in the vaginal cavity associated with a large vulvovaginal mass. An apathetic examination of the specimen had made it possible to diagnose a botryoid sarcoma that affects the cervix and uterine body (Mullerian tumor). Laparotomy had revealed uterine inversion. This required a total hysterectomy with appendectectomy had been performed. Then the patient was transferred to the cancer service for treatment where in the seventh day, she died in the surgery post.展开更多
Uterine inversion is rare. It is classically described as a complication of the delivery period. Non-puerperal uterine inversion is exceptional and usually results from a tumor implanted on fundus of the uterus. We re...Uterine inversion is rare. It is classically described as a complication of the delivery period. Non-puerperal uterine inversion is exceptional and usually results from a tumor implanted on fundus of the uterus. We report two cases of non-puerperal uterine inversion caused by fundal submucosal myoma. Its diagnosis can be difficult and a high index of clinical suspicion is required to make a prompt diagnosis. The delayed diagnosis observed in our cases, caused uterine necrosis, which was managed by hysterectomy. The patients’ post-operative course was uneventful.展开更多
It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice...It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice. The risk of maternal mortality by hemorrhage is high. We report two cases of uterine inversion requiring a hysterectomy, including a postpartum mode and the other gynecological mode with young women. Hysterectomy remained a last resort treatment in the two types, to reduce morbidity. In the case of uterine inversion, the treatments without hysterectomy could be facilitated if the management is early and adequate. Furthermore, the support should be multidisciplinary and fast in the two types.展开更多
Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine wal...Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri? balloon (Cook Medical Incorporated) in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description;and the first one in a third degree recurrent puerperal uterine inversion.展开更多
Uterine leiomyosarcoma (LMS) is a rare uterine malignancy that represents approximately 1% of uterine cancers. The nonspecific symptoms cause difficulties in the diagnostic, prognostic and therapeutic. We report an un...Uterine leiomyosarcoma (LMS) is a rare uterine malignancy that represents approximately 1% of uterine cancers. The nonspecific symptoms cause difficulties in the diagnostic, prognostic and therapeutic. We report an unusual progressive form, with a uterine inversion of LMS fundal externalized out of the vulva in a patient of 48 years old premenopausal.展开更多
A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was perfor...A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was performed for inntractable headache at 32 weeks.Uterine inversion spontaneously occured at cesarean section.Immediately,uterine inversion was corrected manually without difficulty.Uterine atony and postpartum haemorrhage did not occur,and the patient made an remarkable recovery.This case report provides residents with excellent case-based learning.The management of uterine inversion requires immediate treatment for uterine repositioning.All staff members in the maternal unit should be updated with skills and knowledge about uterine inversion.展开更多
Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the managem...Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the management of primary postpartum haemorrhage. Method: A retrospective case-control study of all patients with primary postpartum haemorrhage from January 1, 2001 to December 31, 2010 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Result: In the period under review, 272 cases of primary postpartum haemorrhage were documented while there were a total of 5929 deliveries, giving an incidence of 1 in 26 (25.6%). The average blood loss in the cases reviewed was 1550 mls whilst in the controls, the average blood loss was 200 mls. There was statistical significant difference between the grandmultiparous cases and grandmultiparous controls (58.4% versus 16.5%, OR = 6.74, p < 0.05), suggesting that grandmultiparity may be an implicated factor in primary postpartum haemorrhage. In the unbooked cases, retained placenta was the major cause of primary postpartum haemorrhage constituting 109 (51.7%), whereas in booked cases, uterine atony contributed 70.5% to primary postpartum haemorrhage. Four maternal deaths were recorded giving a case fatality rate of 1.5%;all were unbooked. Conclusion: Postpartum haemorrhage ranks high in the list of causes of maternal death and the case fatality rate can be very high. Prevention is the key to reducing the incidence of PPH and its sequale, with preventive measures based upon the identification of risk factors, surveillance of women at risk and seemingly not at risk and avoidance of procedure during delivery which could potentially result in complications.展开更多
文摘Introduction: Uterine inversion is a reversal of the uterus into a glove. It is an obstetric complication of deliverance. Uterine inversion out from pregnancy is rare. The Müller duct is an embryonic tubular formation which will transform into the vagina, uterus, and fallopian tubes. The mixed Müllerian malignant tumor is a rare tumor to girl and woman in genital activity, which develops in the uterus at the expense of vestige of the Müller channels. The association of these two pathologies is rare. We report an observation of complicated uterine inversion mulloblastoma to a teenager. Observation: A teenager of 15 years old, admitted for a vulvar tumor, which has occurred about two months. Student in the first class of senior high school, she has no medical history, and no particular surgery. She had her threat at the age of 13, and has a regular menstrual cycle of 30 days, with 05 days of period. Two months before her admission, the patient noticed during her menstruation, the perception of soft intravaginal tissue but which disappeared when her period stopped. A week before her admission, she felt pelvic pain with expulsive colic, radiating to the external genitals, 3 days later, a protusion from the vaginal vestibule of a mass, so the volume gradually increased. It is in front of this situation that the patient consults a health center, which refers her to us for treatment. On admission, the patient was conscious with a good hemodynamic state. Vulva inspection revealed a large, rounded mass with an endovaginal implantation, with necrosis areas. This mass was resistant, bleeding in any manipulation, mobile, perceive neither the cervical relief nor the presence of the uterus. The ultrasound assessment had marked: a large abdomino-pelvic pseudo-mass with urinary repercussions right form of hydronephrosis uretero and associated with gastric distension, and MRI complete inversion of the uterus, with the uterine in the vaginal cavity associated with a large vulvovaginal mass. An apathetic examination of the specimen had made it possible to diagnose a botryoid sarcoma that affects the cervix and uterine body (Mullerian tumor). Laparotomy had revealed uterine inversion. This required a total hysterectomy with appendectectomy had been performed. Then the patient was transferred to the cancer service for treatment where in the seventh day, she died in the surgery post.
文摘Uterine inversion is rare. It is classically described as a complication of the delivery period. Non-puerperal uterine inversion is exceptional and usually results from a tumor implanted on fundus of the uterus. We report two cases of non-puerperal uterine inversion caused by fundal submucosal myoma. Its diagnosis can be difficult and a high index of clinical suspicion is required to make a prompt diagnosis. The delayed diagnosis observed in our cases, caused uterine necrosis, which was managed by hysterectomy. The patients’ post-operative course was uneventful.
文摘It is a rare clinical condition that may occur to two possible types: puerperal uterine inversion (IUP) and no puerperal uterine inversion (IUNP). Obstetrician will observe often only once in his professional practice. The risk of maternal mortality by hemorrhage is high. We report two cases of uterine inversion requiring a hysterectomy, including a postpartum mode and the other gynecological mode with young women. Hysterectomy remained a last resort treatment in the two types, to reduce morbidity. In the case of uterine inversion, the treatments without hysterectomy could be facilitated if the management is early and adequate. Furthermore, the support should be multidisciplinary and fast in the two types.
文摘Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri? balloon (Cook Medical Incorporated) in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description;and the first one in a third degree recurrent puerperal uterine inversion.
文摘Uterine leiomyosarcoma (LMS) is a rare uterine malignancy that represents approximately 1% of uterine cancers. The nonspecific symptoms cause difficulties in the diagnostic, prognostic and therapeutic. We report an unusual progressive form, with a uterine inversion of LMS fundal externalized out of the vulva in a patient of 48 years old premenopausal.
基金This work was supported by grants from the Open Fundation of Key Laboratory of Birth Regulation and Control Technology of National Health Commission of China(grant numbers 2018KF003)Medical and Health Science Technology Development Plan of Shandong Province(grant numbers 2018WS274).
文摘A 18-year-old local Han Chinese primigravida woman suffered with severe pre-eclampsia.After blood pressure stabilization,convulsion prophylaxis and fetal lung maturity enhancement,emergency cesarean section was performed for inntractable headache at 32 weeks.Uterine inversion spontaneously occured at cesarean section.Immediately,uterine inversion was corrected manually without difficulty.Uterine atony and postpartum haemorrhage did not occur,and the patient made an remarkable recovery.This case report provides residents with excellent case-based learning.The management of uterine inversion requires immediate treatment for uterine repositioning.All staff members in the maternal unit should be updated with skills and knowledge about uterine inversion.
文摘Objective: To determine the incidence of primary postpartum haemorrhage, identify risk/aetiological factors contributing to primary postpartum haemorrhage and review the different therapeutic approaches in the management of primary postpartum haemorrhage. Method: A retrospective case-control study of all patients with primary postpartum haemorrhage from January 1, 2001 to December 31, 2010 at Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Result: In the period under review, 272 cases of primary postpartum haemorrhage were documented while there were a total of 5929 deliveries, giving an incidence of 1 in 26 (25.6%). The average blood loss in the cases reviewed was 1550 mls whilst in the controls, the average blood loss was 200 mls. There was statistical significant difference between the grandmultiparous cases and grandmultiparous controls (58.4% versus 16.5%, OR = 6.74, p < 0.05), suggesting that grandmultiparity may be an implicated factor in primary postpartum haemorrhage. In the unbooked cases, retained placenta was the major cause of primary postpartum haemorrhage constituting 109 (51.7%), whereas in booked cases, uterine atony contributed 70.5% to primary postpartum haemorrhage. Four maternal deaths were recorded giving a case fatality rate of 1.5%;all were unbooked. Conclusion: Postpartum haemorrhage ranks high in the list of causes of maternal death and the case fatality rate can be very high. Prevention is the key to reducing the incidence of PPH and its sequale, with preventive measures based upon the identification of risk factors, surveillance of women at risk and seemingly not at risk and avoidance of procedure during delivery which could potentially result in complications.
