Expert: Lawrence Jay Rappaport <B>M.D.</B> - 7/7/2004
Question I had a Uterine Inversion during my delivery 5 months ago. After my daughter was born, the doctor told my husband that I had a retained placenta and that I would have to be taken in for surgery to remove it. While they were talking, the resident informed the doctor that "it was out" (the placenta) and apparently, it was taking my uterus with it. She was able to put it back with her fist, but I hemorraged very badly (I had toxemia with HELLP, so the bleeding was pretty bad). They took me into surgery that seemed to go fine.
Then, 6 weeks later I noticed something near my cervix and went back to the doctor. The uterus had inverted again! I had another surgery when my daughter was 8 weeks old, my surgeon performed some kind of miracle in getting the uterus back through the cervix and putting it back into place. There weren't any documented cases of this happening before.
My question is, could this uterus inversion have happened spontaneously, or do you think someone did something wrong? (pulled on the cord, pulled on the placenta, etc) I am just looking for a little peace of mind. Do these kinds of things "just happen"? Was it going to happen to me no matter what? Are there any warning signs that this could happen to someone? The doctors told me the situation was unavoidable, but maybe they are afraid I would sue. I would never do that, all I want is the truth.
thank you so much for your time. Michele
Answer Most inversions of the uterus occur during the delivery of the placenta, if someone exerts too much traction on the umbilical cord. It is rare to have a spontaneous inversion of the uterus, but it can occasionally occur. Usually pushing it back in with the fist will correct the situation. Sometimes uterine packing is placed to "ballot" the uterus until it contracts. Once the uterus contracts, it is unlikely for another inversion to occur. If you had any retained placenta, a D&C should have been done. There are no warning signs of inversion but if you have any heavy bleeding or feel a mass in the vagina, have it checked out.
