{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:27:14Z","timestamp":1773073634474,"version":"3.50.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T00:00:00Z","timestamp":1601596800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18\u2009weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8\u2009\u00b0C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12905-020-01089-0","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T12:03:02Z","timestamp":1601640182000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Subacute uterine inversion following an induced abortion in a teenage girl: a case report"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5594-0310","authenticated-orcid":false,"given":"Asiphas","family":"Owaraganise","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leevan","family":"Tibaijuka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Ngonzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,10,2]]},"reference":[{"issue":"7","key":"1089_CR1","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1097\/OGX.0000000000000580","volume":"73","author":"MP Wendel","year":"2018","unstructured":"Wendel MP, Shnaekel KL, Magann EF. Uterine inversion: a review of a life-threatening obstetrical emergency. Obstet Gynecol Surv. 2018;73(7):411\u20137.","journal-title":"Obstet Gynecol Surv"},{"issue":"4","key":"1089_CR2","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1007\/s13224-017-1040-1","volume":"68","author":"S Mishra","year":"2018","unstructured":"Mishra S. Chronic uterine inversion following mid-trimester abortion. J Obstetr Gynecol India. 2018;68(4):320\u20132.","journal-title":"J Obstetr Gynecol India"},{"key":"1089_CR3","volume-title":"World Health Organisation, Managing complications in pregnancy and childbirth: a guide for midwives and doctors: World Health Organization","author":"WHO","year":"2017","unstructured":"WHO. World Health Organisation, Managing complications in pregnancy and childbirth: a guide for midwives and doctors: World Health Organization; 2017."},{"issue":"1","key":"1089_CR4","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1576\/toag.11.1.13.27463","volume":"11","author":"R Bhalla","year":"2009","unstructured":"Bhalla R, Wuntakal R, Odejinmi F, Khan RU. Acute inversion of the uterus. Obstet Gynaecol. 2009;11(1):13\u20138.","journal-title":"Obstet Gynaecol"},{"issue":"3","key":"1089_CR5","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.ajog.2017.05.018","volume":"217","author":"SL Coad","year":"2017","unstructured":"Coad SL, Dahlgren LS, Hutcheon JA. Risks and consequences of puerperal uterine inversion in the United States, 2004 through 2013. Am J Obstet Gynecol. 2017;217(3):377 e1-. e6.","journal-title":"Am J Obstet Gynecol"},{"issue":"3","key":"1089_CR6","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/j.1600-0412.2012.01514.x","volume":"92","author":"T Witteveen","year":"2013","unstructured":"Witteveen T, van Stralen G, Zwart J, van Roosmalen J. Puerperal uterine inversion in the Netherlands: a nationwide cohort study. Acta Obstet Gynecol Scand. 2013;92(3):334\u20137.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"3","key":"1089_CR7","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1111\/j.1447-0756.1997.tb00852.x","volume":"23","author":"SM Dali","year":"1997","unstructured":"Dali SM, Rajbhandari S, Shrestha S. Puerperal inversion of the uterus in Nepal: case reports and review of literature. J Obstet Gynaecol Res. 1997;23(3):319\u201325.","journal-title":"J Obstet Gynaecol Res"},{"issue":"2","key":"1089_CR8","doi-asserted-by":"publisher","first-page":"120","DOI":"10.3122\/15572625-13-2-120","volume":"13","author":"DR Hostetler","year":"2000","unstructured":"Hostetler DR, Bosworth MF. Uterine inversion: a life-threatening obstetric emergency. J Am Board Fam Pract. 2000;13(2):120\u20133.","journal-title":"J Am Board Fam Pract"},{"issue":"3","key":"1089_CR9","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/0028-2243(88)90133-5","volume":"27","author":"S Lipitz","year":"1988","unstructured":"Lipitz S, Frenkel Y. Puerperal inversion of the uterus. Eur J Obstet Gynecol Reprod Biol. 1988;27(3):271\u20134.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"2 Pt2","key":"1089_CR10","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1097\/01.AOG.0000252260.11235.33","volume":"109","author":"SL Livingston","year":"2007","unstructured":"Livingston SL, Booker C, Kramer P, Dodson WC. Chronic uterine inversion at 14 weeks postpartum. Obstet Gynecol. 2007;109(2 Pt2):555\u20137.","journal-title":"Obstet Gynecol"},{"issue":"7","key":"1089_CR11","first-page":"e2904","volume":"10","author":"JA Ronen","year":"2018","unstructured":"Ronen JA, Castaneda K, Sadre SY. Early accreta and uterine rupture in the second trimester. Cureus. 2018;10(7):e2904.","journal-title":"Cureus"},{"issue":"4","key":"1089_CR12","doi-asserted-by":"publisher","first-page":"e9878","DOI":"10.5812\/iranjradiol.9878v2","volume":"12","author":"V Mihmanli","year":"2015","unstructured":"Mihmanli V, Kilic F, Pul S, Kilinc A, Kilickaya A. Magnetic resonance imaging of non-puerperal complete uterine inversion. Iran J Radiol. 2015;12(4):e9878.","journal-title":"Iran J Radiol"},{"issue":"3","key":"1089_CR13","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1007\/s00404-002-0425-1","volume":"269","author":"DT Parikshit","year":"2004","unstructured":"Parikshit DT, Niranjan MM, Nandanwar Y. Pregnancy outcome after operative correction of puerperal uterine inversion. Arch Gynecol Obstet. 2004;269(3):214\u20136.","journal-title":"Arch Gynecol Obstet"},{"issue":"1","key":"1089_CR14","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1186\/1752-1947-8-347","volume":"8","author":"RFM Leal","year":"2014","unstructured":"Leal RFM, Luz RM, de Almeida JP, Duarte V, Matos I. Total and acute uterine inversion after delivery: a case report. J Med Case Rep. 2014;8(1):347.","journal-title":"J Med Case Rep"},{"issue":"9","key":"1089_CR15","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1097\/00006254-199809000-00023","volume":"53","author":"GN Smith","year":"1998","unstructured":"Smith GN, Brien JF. Use of nitroglycerin for uterine relaxation. Obstet Gynecol Surv. 1998;53(9):559\u201365.","journal-title":"Obstet Gynecol Surv"},{"issue":"4","key":"1089_CR16","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1046\/j.1469-0705.1998.12040283.x","volume":"12","author":"H Ward","year":"1998","unstructured":"Ward H. O'Sullivan's hydrostatic reduction of an inverted uterus: sonar sequence recorded. Ultrasound Obstet Gynecol. 1998;12(4):283\u20136.","journal-title":"Ultrasound Obstet Gynecol"},{"issue":"3","key":"1089_CR17","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1016\/0028-2243(89)90048-8","volume":"32","author":"AW Momani","year":"1989","unstructured":"Momani AW, Hassan A. Treatment of puerperal uterine inversion by the hydrostatic method; reports of five cases. Eur J Obstet Gynecol Reprod Biol. 1989;32(3):281\u20135.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"15","key":"1089_CR18","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1056\/NEJM192104141841504","volume":"184","author":"JL Huntington","year":"1921","unstructured":"Huntington JL. Acute inversion of the uterus. Boston Med Surg J. 1921;184(15):376\u201380.","journal-title":"Boston Med Surg J"},{"issue":"1","key":"1089_CR19","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1097\/01.grf.0000197544.87808.9c","volume":"49","author":"WB You","year":"2006","unstructured":"You WB, Zahn CM. Postpartum hemorrhage: abnormally adherent placenta, uterine inversion, and puerperal hematomas. Clin Obstet Gynecol. 2006;49(1):184\u201397.","journal-title":"Clin Obstet Gynecol"},{"issue":"6","key":"1089_CR20","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1111\/j.1600-0412.2012.01513.x","volume":"92","author":"S Matsubara","year":"2013","unstructured":"Matsubara S, Baba Y. MY (Matsubara\u2013Yano) uterine compression suture to prevent acute recurrence of uterine inversion. Acta Obstet Gynecol Scand. 2013;92(6):734\u20135.","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"5","key":"1089_CR21","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/j.jmig.2009.06.001","volume":"16","author":"N Sardeshpande","year":"2009","unstructured":"Sardeshpande N, Sawant R, Sardeshpande S, Sabnis S. Laparoscopic correction of chronic uterine inversion. J Minim Invasive Gynecol. 2009;16(5):646\u20138.","journal-title":"J Minim Invasive Gynecol"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-01089-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-020-01089-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-020-01089-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,21]],"date-time":"2022-11-21T23:31:15Z","timestamp":1669073475000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-020-01089-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,2]]},"references-count":21,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["1089"],"URL":"https:\/\/doi.org\/10.1186\/s12905-020-01089-0","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,2]]},"assertion":[{"value":"25 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 September 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 October 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"We obtained ethical approval for publication from the Institutional Review Board of Mbarara University of Science and Technology.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s parent\/guardian for publication of this Case report and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"220"}}