Manual repositioning using the Johnson method combined with intrauterine condom-catheter tamponade successfully managed puerperal uterine inversion in all three cases, avoiding hysterectomy.
Case Report (n=3)
No
Does manual repositioning combined with intrauterine condom-catheter tamponade successfully manage puerperal uterine inversion?
Manual repositioning combined with intrauterine condom-catheter tamponade is an effective non-surgical approach for managing puerperal uterine inversion in low-resource settings.
Puerperal uterine inversion is a rare yet life-threatening obstetric emergency that may lead to severe Postpartum Hemorrhage (PPH), whereas PPH remains a leading cause of maternal mortality. Prompt diagnosis and intervention are crucial to prevent fatal outcomes. We report three cases of puerperal uterine inversion managed at a tertiary teaching hospital in Indonesia between 2020 and 2024. Risk factors identified included multiparity, prolonged labor, baby birth weight >3000 gr, inadequate third-stage management including aggressive cord traction, history of misoprostol use, manual placenta and uterine atony. All cases were successfully managed with manual repositioning (Johnson's method) and intrauterine condom-catheter tamponade (average blood loss 983 mL), avoiding the need for hysterectomy. This combined non-surgical approach demonstrated high effectiveness in a low-resource setting. A critical finding was frequent misdiagnosis at primary care facilities contributed to delays in management. Strengthening birth attendant skills is crucial for preventing uterine inversion, immediate recognition and early intervention.
Hariani et al. (Fri,) conducted a case report in Puerperal uterine inversion (n=3). Manual repositioning (Johnson's method) and intrauterine condom-catheter tamponade was evaluated on Successful management without the need for hysterectomy. Manual repositioning using the Johnson method combined with intrauterine condom-catheter tamponade successfully managed puerperal uterine inversion in all three cases, avoiding hysterectomy.