Successful Management of Acute Puerperal Uterine Inversion After Vaginal Delivery: A Case Report of a 43-Year-Old Multiparous Woman

Acute puerperal uterine inversion is a rare but life-threatening obstetric emergency, with a reported incidence ranging from approximately 1 in 2,000 to 1 in 20,000 deliveries. It is characterized by inward displacement of the uterine fundus into or through the endometrial cavity following childbirth. This report highlights a case of acute uterine inversion in a 43-year-old multiparous woman who developed severe postpartum hemorrhage after vaginal delivery. Physical examination revealed a protruding mass through the cervix, consistent with complete uterine inversion. Following prompt fluid resuscitation and administration of uterine relaxants, manual replacement using the Johnson maneuver was successfully performed, followed by uterotonic therapy. The patient recovered without complications and was discharged on postpartum day 4. This case aims to increase awareness that early diagnosis and immediate uterine replacement are crucial for achieving favorable maternal outcomes and preserving reproductive potential.