Uterine Inversion After Delivery: Understanding Risks & Recovery

Question
Hi Kristy,

I had a vaginal delivery of my daughter in February 06 and in June 06 went to the emergency room for abdominal pain turns out I lived with a uterine inversion for 3 months. How could my midwife and assisted doctor not know this occurred I had a rough delivery with a 4th degree tear she was 8lbs and 13ounces.  
Thank God I found a excellent doctor to correct, but I believe they could have prevented already knowing I had a rough assisted delivery.  What are my chances of it happening again if I don't have another baby?
Thanks for opinion!


Answer
Hi Chassity,

Wow, unbeleivable that this was missed during the delivery of your daughter ...

I dont know what degree your inversion was ..incase you didnt know, there are 3 grades of this condition, those being ..

First-degree: On pressing on perineum, cervix visible
Second-degree: Cervix protrudes via vaginal introitus
Third-degree: Entire uterus is external to introitus


If yours in in the first degree, its generally mild and can be prevented from happening again, with simple exercise such as keegle excercise ..Also, depending on your age, hormone therapy could also be a good preventative measure as well.

Ofcourse, if you were to get pregnant again, your chances will GREATLY increase of this happening again. The higher grade of this condition (As mentioned above) the more serious complications there are.

Those complications being ..

Risk of prolapse in subsequent pregnancies.
Exposed vaginal epithelium may become thickened, dry and ulcerated.
Supravaginal cervix may become elongated; vaginal portion may become oedematous and enlarged.


If your condition was of serious grade, there are preventive measures you can take, such as ..

pelvic floor strengthening exercises antenatally may help;

Mild cases may not require more than pelvic floor strengthening exercises (hormone replacement may help in postmenopausal women)

Some serious results, often end in hysterectomy as well ..

This can be a potentially serious situation( I am sure you are aware) but given with you that this went on so long, I think your condition was on the mild side ..

You definately are at risk of this happening again, if you were to become pregnant. You will significally lower the risks, by not becoming pregnant, and its unlikely to happen again.

Hope this was of some help.

-Kristy