Open AccessPuerperal uterine inversion in the Netherlands: a nationwide cohort study
Author(s) -
Witteveen Tom,
Stralen Giel,
Zwart Joost,
Roosmalen Jos
Publication year - 2013
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01514.x
Subject(s) - medicine , complication , etiology , incidence (geometry) , obstetrics , cohort , medical record , uterine inversion , cohort study , population , gynecology , retrospective cohort study , pediatrics , uterine rupture , surgery , uterus , physics , environmental health , optics
Puerperal uterine inversion is a severe but rare obstetric complication of yet unknown origin. In this two‐year study we determine the incidence of this complication and we describe associated risk factors to expose its etiology. All cases of uterine inversion were included from a nationwide cohort study which contained all 98 hospitals with a maternity unit in the Netherlands. We reviewed the medical records of 15 patients, resulting an incidence of approximately 1 in 20 000 vaginal births. Fourteen cases (93.3%) were classified as low‐risk pregnancies at booking. Nulliparous women were not overrepresented and the main associated factors were signs of prolonged labor followed by third stage manipulation. This study is the first population‐based study for uterine inversion. With the reported associated factors and occurrence in women with a low‐risk profile, we show that every birth attendant should be able to detect this rare but severe complication.