An acute postpartum uterine inversion – a near miss case: challenges of management in a resource limited setting – a case report

Introduction and importance: Acute postpartum uterine inversion is a rare but life-threatening obstetric emergency that can rapidly lead to catastrophic hemorrhage and shock, especially in a resource-limited setting. This case report highlights the importance of prompt diagnosis, timely referral, and multidisciplinary management in achieving favorable maternal outcomes. Case presentation: A 25-year-old multiparous woman developed acute complete uterine inversion after an uncomplicated vaginal delivery at a lower-level healthcare facility. Initial resuscitative measures were initiated, and attempted manual repositioning was unsuccessful before referral to the national referral hospital. On arrival, the diagnosis was confirmed, and surgical correction was successfully achieved using a combined abdominal traction and vaginal push technique. Clinical discussion: This case demonstrates the diagnostic and management challenges associated with acute uterine inversion in a resource-limited setting and emphasizes the importance of rapid referral, coordinated multidisciplinary care, and timely surgical intervention. Conclusion: Acute uterine inversion remains a rare but potentially fatal obstetric event. Appropriate management of the third stage of labor can prevent uterine inversion, and early detection with timely management is essential to improve maternal outcomes.