Akute Inversio uteri puerperalis: Eine Falldarstellung

Zusammenfassung

Die puerperale Uterusinversion ist eine seltene aber lebensbedrohliche geburtshilfliche Komplikation. Nicht erkannt kann es zu schweren Blutungen und Schock bis hin zum mütterlichen Tod führen. Eine manuelle Reposition unter Vollnarkose ist meistens erfolgreich. Bei resistenten Inversionen kann eine Korrektur per Laparotomie hinzugezogen werden. In jedem Fall können die Mortalität und Morbidität durch rechtzeitige Erkennung und zügige Reposition vermindert werden. Daher sollten regelmäßige praktische Übungen zur Erkennung und Behandlung der akuten uterinen Inversion, wie auch andere geburtshilfliche Notfälle im Rahmen der Facharztausbildung erfolgen. Wir berichten über eine 31-jährige II. Gravida 0. Para in der 39+4. Schwangerschaftswoche (SSW), bei der eine akute Inversio uteri dritten Grades nach einer spontanen Entbindung aufgetreten war, die bei frustraner vaginaler Reposition per Laparotomie in Intubationsnarkose reponiert wurde.

Abstract

Puerperal inversion of the uterus is a rare but life-threatening obstetric complication. Unrecognized, it can lead to severe bleeding and shock and even maternal death. Manual replacement under general anesthesia is usually successful. If the manual replacement fails, surgical replacement by laparotomy needs to be performed. In any case, mortality and morbidity can be reduced by rapid recognition and immediate replacement. Therefore, regular practical exercises for the detection and treatment of acute uterine inversion as well as other obstetric emergencies should be performed as part of medical training. We would like to report of a 31-year-old Gravida 2 Para 0 at 39 weeks+4 days of gestation who, after an uncomplicated spontaneous vaginal delivery, had an acute third-degree uterine inversion, which was replaced by laparotomy after an unsuccessful vaginal replacement attempt.

Schlüsselwörter

Postpartum hemorrhage - Primipara - Uterine inversion

Key words

Postpartale Blutung - Primipara - Inversio uteri

Publication History

Received: 04 April 2020

Accepted after revision: 22 August 2020

Article published online:
29 September 2020

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