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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 01

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Ginecol Obstet Mex 2021; 89 (01)

Total uterine inversion secondary to submucosal leiomyoma

Martínez-Rodríguez JJ, Velázquez-Castellanos PI, Macías-Vera NN, Antonio-Matías LJ

Language: Spanish
References: 42
Page: 58-70
PDF size: 229.34 Kb.


ABSTRACT

Background: Uterine inversion is a rare birth complication that occurs immediately after the expulsion of the placenta; it consists of the inversion of the uterus within its own cavity.
Clinical case: 49 years-old patient, native and resident of the State of Mexico, with a body mass index of 21.4 kg/m2, denied chronic-degenerative and toxicological antecedents. History of interest: 3 pregnancies, 3 births, in transition to menopause. The current condition had started 6 months before, with abnormal uterine bleeding, characterized by hyperpolymenorrhea. In the directed physical examination, pelvic organ prolapse was observed, with inversion of the uterine structures, associated with a severe infectious process, with clinical data of hypovolemic shock and risk of organic dysfunction due to sepsis. Uterine inversion was suspected and treated with transfusion of blood products and antibiotics. Abdominal hysterectomy showed uterine inversion secondary to submucosal myoma. The histopathological study confirmed the diagnosis and ruled out malignancy. His evolution was adequate, and he was discharged from the hospital 8 days after the surgery.
Conclusions: The diagnosis is difficult; however, the antecedent of tumor in the uterus associated with the clinical picture described made suspect the problem. In very young patients or those in the postmenopausal stage, it is important to rule out a malignant tumour. Surgical access will depend on the surgeon’s skills.


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