Uterine inversion is a rare but serious complication during childbirth where your uterus turns partially or entirely inside out. Without treatment, an inverted uterus can lead to severe blood loss, shock and even death. Having a care team that’s prepared for emergencies can prevent these outcomes from happening.
Uterine inversion (inverted uterus) is a rare emergency complication during childbirth where your uterus turns partially or completely inside out. With healthy deliveries, your baby exits your uterus (womb) and travels through your vaginal canal to be born. Shortly after, you’ll deliver the placenta, an organ that allows you to share nutrients with your baby during pregnancy. The placenta is called “afterbirth” once it leaves your body. Your uterus maintains its shape throughout delivery.
With uterine inversion, the top part of your uterus collapses inside the uterine cavity. It may even turn inside-out and extend outside your vagina. When this happens, severe blood loss, shock and death can follow.
A prepared care team that acts quickly can prevent these outcomes.
There are four classifications of uterine inversion, depending on how inside out your uterus is and the extent that it projects onto other organs:
The majority of people with uterine inversion fall into the 2nd or 3rd-degree categories.
Uterine inversion is rare. It happens in anywhere from 1 in 3,500 to 1 in 20,000 deliveries. Most often, it occurs within the first 24 hours of delivery (acute uterine inversion). Less often, you may be diagnosed with uterine inversion within one month after having your baby (subacute uterine inversion) or after a month (chronic uterine inversion).
Not enough evidence exists to know for sure what causes an inverted uterus.
A popular theory is that your uterus may invert if your provider tugs on the umbilical cord too hard when trying to deliver the placenta. This isn’t an error on your provider’s part. Instead, it’s one of many complications that can occur during delivery.
Your provider may pull on the umbilical cord — the organ that connects your baby to the placenta — while placing gentle pressure on your abdomen to coax the placenta out. This is a delivery method called the Crede maneuver. This process is more likely to cause your uterus to invert if:
It’s hard to prove this theory, though, because uterine inversion has taken place outside these conditions. Also, delivery methods like the Crede maneuver are common and rarely lead to uterine inversion.
The following risk factors are present in about half of uterine inversion cases:
Uterine inversion can cause severe blood loss and shock. Symptoms will vary, depending on how extreme the inversion is:
Symptoms of shock include:
Your provider will be able to diagnose complete inversions just by looking. A visible uterus and heavy bleeding are telltale signs of an inverted uterus. Your provider may feel your abdomen to see if your uterus has shifted out of place.
Diagnosis has to happen quickly so that life-saving treatment can begin immediately.
Successful treatment depends on your provider’s ability to act quickly to keep your vitals stable while the top of your uterus is placed into its original position. The care you receive depends on the degree of inversion. It may involve:
Lifesaving procedures are performed in an operating room. Once the bleeding has stopped, you may be moved to the ICU so that blood products can be administered. You’ll be given blood transfusions as needed.
Uterine inversion can’t be prevented, but it can be effectively treated if your care team acts quickly.
Uterine inversion can be life-threatening if it’s not managed correctly. The survival rate is excellent, though, with a care team that’s prepared for emergencies. People who receive this care go on to lead healthy lives with no long-term complications.
People with uterine inversion have gone on to have successful pregnancies. Still, more data is needed to understand what uterine inversion means for future pregnancies. Your provider should know if you have a history of uterine inversion. This information can help guide your care plan moving forward.
In addition to eating healthy, drinking plenty of fluids and getting as much rest as you can after a uterine inversion, take care to follow your provider’s guidance. Your home care will depend on how extensive your treatment was, how much blood you lost, etc. For instance, you may need to complete follow-up bloodwork or take iron supplements for blood loss. Follow your provider’s advice.
A note from Cleveland Clinic
It’s unlikely that you’ll experience uterine inversion. If you do, having a care team that provides treatment right away can save your life. Talk to your provider about any concerns you may have about emergency complications, like uterine inversion. Ask about the protocols in place to provide life-saving care if an emergency arises.
Last reviewed by a Cleveland Clinic medical professional on 01/25/2022.
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