U-turn of uterine arteries: a novel sign pathognomonic of uterine inversion.

A uterine inversion occurs when the uterine fundus collapses into the endometrial cavity. It is a rare complication in obstetrics following delivery, and it is even more infrequently encountered in gynecology with the non-puerperal uterus. A submucous fibroid is the most common reported cause of the non-puerperal uterine inversion. If not promptly recognized and treated, uterine inversion may lead to a severe hemorrhagic shock and death. We describe a novel three-dimensional power Doppler feature for the diagnosis of uterine inversion.

Non-puerperal uterine inversion associated with myomatosis.

Uterine inversion is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. In this way, uterine inversions are classified into two groups, being of puerperal origin due to obstetric problems and non-puerperal origin due to gynecological problems. In general, a non-puerperal uterine inversion occurs as a possible complication of a sub mucosal leiomyoma, after an expansive process, a dilation of the cervix occurs and thus its protuberance over the vaginal canal.

Non-puerperal uterine inversion associated with myomatosis

SUMMARY Uterine inversion is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. In this way, uterine inversions are classified into two groups, being of puerperal origin due to obstetric problems and non-puerperal origin due to gynecological problems. In general, a non-puerperal uterine inversion occurs as a possible complication of a sub mucosal leiomyoma, after an expansive process, a dilation of the cervix occurs and thus its protuberance over the vaginal canal.

RESUMO A inversão uterina é uma complicação incomum do puerpério e é uma complicação ainda mais rara do período não puerperal. Dessa forma, as inversões uterinas são classificadas em dois grupos, sendo as de origem puerperal decorrentes de problemas obstétricos e as inversões de origem não puerperal decorrentes de problemas ginecológicos. Em geral, a inversão uterina não puerperal decorre como uma possível complicação de um leiomioma submucoso — após o processo expansivo, ocorre a dilatação do colo uterino e, dessa forma, a sua protusão sobre o canal vaginal.

Color Doppler examination for the diagnosis of subacute puerperal uterine inversion.

PURPOSE: Obstetric uterine inversion is a rare and life-threatening complication. Diagnosis is often difficult to establish, particularly in recurrent or chronic cases. METHOD: We performed color Doppler examination in addition to B-mode sonography in a case of subacute recurrent uterine inversion. RESULTS: Identification of the vessels providing uterine blood supply helped to clarify the distorted anatomy; furthermore, information about tissue viability was gained. CONCLUSION: We propose to perform color Doppler examination in all cases with suspected uterine inversion or vaginal masses of unknown origin.

Sonographic diagnosis of complete uterine inversion: an unusual case.

Complete puerperal uterine inversion is an uncommon but potentially life-threatening obstetric emergency. It generally occurs as an obstetrical complication in the postpartum period and can present in acute, subacute, and chronic forms depending on the time interval after delivery. Maternal mortality has been reported to be as high as 15%, mainly because of life associated threatening blood loss and shock. Early diagnosis and treatment are essential, but diagnosis of this is not simple. This is a report of unusual case of complete uterine inversion diagnosed by accurate ultrasound leading to prompt potentially life-saving treatment.

Sonographic findings in acute uterine inversion.

We present a case of acute uterine inversion in the third stage of labor in which critical management decisions were facilitated by ultrasound imaging in the operating room. Identification of the ovary and adnexa pulled into the indentation of the inversion allowed the successful diagnosis and guidance for uterine replacement.

Ultrasound diagnosis of complete uterine inversion in a nulliparous woman.

Non-puerperal uterine inversion is an extremely rare event, and the diagnosis is made during vaginal examination or exploratory laparotomy. We report a case of complete uterine inversion which was diagnosed on abdominal ultrasound examination in a 50-year-old nulliparous virgin who was admitted to the hospital because of profuse vaginal bleeding, lower abdominal pain and anuria. The confirmatory diagnosis of complete uterine inversion secondary to a fundal fibroid was made at exploratory laparotomy. Total abdominal hysterectomy was performed, and the pathological examination confirmed its benign nature. Ultrasound evaluation is useful in the diagnosis of non-puerperal uterine inversion.

Ultrasound diagnosis and comprehensive surgical treatment of complete non-puerperal uterine inversion.

INTRODUCTION: Ultrasonographic diagnosis of very rare case of complete non-puerperal uterine inversion secondary to a large sub-mucous fibroid. CASE REPORT: A 50-year-old woman was admitted with heavy vaginal bleeding. Detailed vaginal and abdominal ultrasound, using color Doppler flow, raised the suspicion of complete uterine inversion. The distal ends of the fallopian tubes and part of the ovaries were demonstrated adherent to the uterine fundus. Laparoscopy showed there was no uterus inside the abdomen because of complete uterine inversion. Only a dimple with a constriction ring was found at the site of the uterus. A sub-mucous 6 cm fibroid was attached to the fundus, and vaginal myomectomy was performed to reduce uterine size in order to restore the uterus to its abdominal position. However, the uterus was impacted and only cutting longitudinally the anterior and posterior fornices helped to restore the uterus and facilitate an abdominal hysterectomy. Histological examination of the uterus and fibroid following hysterectomy confirmed their benign nature. CONCLUSION: Ultrasonographic diagnosis of complete uterine inversion is feasible. However, high index of suspicion is necessary.

Sonography of postpartum uterine inversion from acute to chronic stage.

We report the sonographic appearance of postpartum uterine inversion progressing from acute partial to chronic stage after an 8-week interval. The delay in diagnosis was partly due to the patient's stable clinical condition except for minor vaginal discharge and bleeding. The diagnosis of chronic inversion on the follow-up sonographic examination prompted clinicians to undertake surgical repair. Our case shows that the prompt use of sonography during labor and in the peripartum should be sufficient to establish the diagnosis of this serious postpartum complication, which can result in shock or even death. Sonography findings can be considered characteristic and fairly accurate in this condition.

Non-puerperal uterine inversion associated with endometrial carcinoma--a case report.

BACKGROUND: Non-puerperal uterine inversion is rare, and a case associated with endometrial carcinoma is even rarer. It is difficult to diagnose the condition preoperatively and most cases are diagnosed at surgery. CASE: We describe a case of uterine inversion associated with endometrial carcinoma. Initially, the patient was thought to have a cervical adenocarcinoma and treated with chemotherapy; however, a diagnosis of uterine inversion was made with magnetic resonance imaging (MRI) and ultrasonography during pre-surgical chemotherapy. We performed total abdominal hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy. CONCLUSION: MRI and ultrasonography can be extremely useful tools for diagnosing uterine inversion.