Bernaschek G
Zentralbl Gynakol. 1979;101(19):1266-9.
Inversion of uterus in puerperium is an extremely rare case and always accompanied by severe shock. To the obstetrician such event is almost always unexpected and calls for immediate decision and action. Dry manual reposition usually is impossible for tough inversion pressure, while severe disadvantages are implied in vaginal surgery with incision of the anterior and posterior walls of the uterus. Therefore, an abdominal method is recommended by the author, leaning on Huntington's technique. First, the shock is brought under control. Then the inverted uterus is levered out of the inversion funnel to complete reversion, step by step, with a pair of bullet forceps inserted after each step, four altogether. The uterus of two cases was completely reversed by means of that simple method in 30 minutes only. Even the most careful and vigilant obstetrician may find himself trapped in such rare situation of spontaneous uterus inversion due to the constitution of a particular patient. The procedure suggested in this paper, therefore, may be an approach practicable even in smaller and less equipped hospitals, when it comes to the need for immediate remedial action to cope with that most dangerous complication.