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Subacute uterine inversion following an induced abortion in a teenage girl: a case report

BACKGROUND: Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. CASE PRESENTATION: We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe...

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Autores principales: Owaraganise, Asiphas, Tibaijuka, Leevan, Ngonzi, Joseph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532615/
https://www.ncbi.nlm.nih.gov/pubmed/33008375
http://dx.doi.org/10.1186/s12905-020-01089-0
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author Owaraganise, Asiphas
Tibaijuka, Leevan
Ngonzi, Joseph
author_facet Owaraganise, Asiphas
Tibaijuka, Leevan
Ngonzi, Joseph
author_sort Owaraganise, Asiphas
collection PubMed
description BACKGROUND: Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. CASE PRESENTATION: We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. CONCLUSION: Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.
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spelling pubmed-75326152020-10-05 Subacute uterine inversion following an induced abortion in a teenage girl: a case report Owaraganise, Asiphas Tibaijuka, Leevan Ngonzi, Joseph BMC Womens Health Case Report BACKGROUND: Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. CASE PRESENTATION: We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. CONCLUSION: Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity. BioMed Central 2020-10-02 /pmc/articles/PMC7532615/ /pubmed/33008375 http://dx.doi.org/10.1186/s12905-020-01089-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Owaraganise, Asiphas
Tibaijuka, Leevan
Ngonzi, Joseph
Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title_full Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title_fullStr Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title_full_unstemmed Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title_short Subacute uterine inversion following an induced abortion in a teenage girl: a case report
title_sort subacute uterine inversion following an induced abortion in a teenage girl: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532615/
https://www.ncbi.nlm.nih.gov/pubmed/33008375
http://dx.doi.org/10.1186/s12905-020-01089-0
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