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Inversión uterina puerperal: experiencia en nuestro centro
Authors:Teresa Lozoya Araque  Isauro Rogelio Monfort OrtizLaura Rubert Torró  Julia Renard MeseguerVicente José Diago Almela  Alfredo José Perales Marín
Institution:Servicio de Obstetricia y Ginecología, Hospital Universitari i Politècnic La Fe, Valencia, España
Abstract:

Objective

To assess the incidence, outcomes, and risk of recurrence of puerperal uterine inversion in our hospital.

Material and methods

A retrospective study was carried out in 22 cases of puerperal uterine inversion from January 1993 to December 2013 in our hospital. We analyzed different risk factors.

Results

The mean age of the patients was 28 years (18-41). Nineteen (86%) were nulliparous. Four (18%) had undergone previous uterine surgery. Delivery was through cesarean section in 6 patients (27%) and through the vaginal route in 16 (73%). The mean birthweight was 3111 grams (2130-3950). Retained placenta occurred in 8 patients (36.4%) and uterine atony in 3 (13.6%). Uterine inversion was acute in all patients. Complications and management consisted of severe hemorrhage in 7 patients, 20 cases (91%) were resolved by the Johnson procedure, and 22 hysterectomies (9%) were performed. There were no deaths and no recurrences.

Conclusions

In our study, important risk factors were nulliparity and placenta accreta. Early diagnosis and treatment are of the utmost importance. Surgery should be the last option.
Keywords:Hemorragia posparto  Inversió  n uterina  Placenta accreta  Atoní  a uterina  Complicaciones del trabajo de parto
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