Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report

Innocent Anayochukwu Ugwu; Boniface Uwaezuoke Odugu; Celestine Chukwudi Obiora; Perpetua Kelechi Enyinna; Chude Chukwuka Eze; Innocent Igwebueze Okafor

doi:doi:10.11648/j.wjmcr.20200101.12

Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report

Innocent Anayochukwu Ugwu, Boniface Uwaezuoke Odugu, Celestine Chukwudi Obiora, Perpetua Kelechi Enyinna, Chude Chukwuka Eze, Innocent Igwebueze Okafor

Published in World Journal of Medical Case Reports (Volume 1, Issue 1)

Received: 11 August 2020 Accepted: 26 August 2020 Published: 7 September 2020

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Abstract

Uterine inversion which commonly occurs during the puerperium is the descent of the fundus of the uterus into or through the cervix thereby keeping the uterus in an ‘inside out’ position. Other structures such as the ovaries and fallopian tubes may also be displaced from the pelvis and restricted within the inverted uterus. However, non puerperal uterine inversion is very rare and represents about one-sixth of all inversion. The most common implicating factor in non-puerperal inversion is prolapsed fibroid with occasional reports of endometrial polyp and uterine neoplasia. Diagnosis of non-puerperal uterine in version may pose a major problem and treatment in women of reproductive age who desire future fertility may involve conservative surgeries. Case Report: We report a case of a 35 year old nulliparous woman with complaints of sudden protrusion of a mass from her vagina with associated cramping lower abdominal pain and vaginal bleeding. A diagnosis of non puerperal uterine inversion due to sub mucous uterine fibroid was made. Surgical interventions done included excision of fibroid and rectification of the uterus through Haultain’s procedure. Histology confirmed uterine fibroid and patient had resumed normal menstrual flow. Conclusion: High index of suspicion is essential for proper diagnosis of non-puerperal uterine in version. In the setting of fertility sparing surgeries, malignancy need to be ruled out, and the woman must be counseled on interval to next pregnancy and risks associated with different modes of delivery.

Published in	World Journal of Medical Case Reports (Volume 1, Issue 1)
DOI	10.11648/j.wjmcr.20200101.12
Page(s)	5-8
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Non-puerperal Uterine Inversion, Uterine Inversion, Sub-mucous Uterine Fibroid, Complete Inversion

References

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[2]	M. De Vries, D. A. Perquin, “Non-puerperal uterine inversion due to sub-mucous myoma in a young woman: a case report”, J Med Case Rep 2010 4: 21.
[3]	E. Nahid (2007) “Nonpuerperal uterine inversion in a virgin woman”, Iranian Journal of Reproductive Medicine5: pp. 135-136. Online; Available at: http://www.bioline.org.br/pdf?rm07028 Accessed 5 August, 2020.
[4]	V. Gowri, “Uterine inversion and corpus malignancies. A historical review”, Obset Gynecol Surv. 2000; 55: pp. 703–707.
[5]	A. Tahere, “Non-puerperal uterine inversion: A case report”, Arch Iranian Med 2005, 8: 63-66. Online; Available at: http://razi.ams.ac.ir/AIM/0581/0015.pdf Accessed 5 August 2020.
[6]	T. T. Hsieh, J. D. Lee, “Sonographic findings in acute puerperal uterine inversion”. J Clin Ultrasound 1991, 19: 306e9.
[7]	M. Auber, B. Darwish, A. Lefebure, J. Ness, H. Roman, “Magnetic resonance imaging of non-puerperal complete uterine”. Iran J Radiol 2015; 12 (4): e9878.
[8]	J. S. Lewin, P. J. Bryan, “MR imaging of uterine inversion”. J Comput Assist Tomogr 1989; 13 (2): 357e9.
[9]	F. Shamsudin, K. Morton (2007)”Novel correction technique of chronic puerperal inversion of the uterus”, J Obstet Gynaecol, 2007, 27: pp. 197-198.
[10]	M. Shivanagappa, Bhandiwad A, M. Mahesh, “A case of acute on chronic uterine inversion with fibroid polyp”. J Clin Diagn Res 2013, 7: PP 2587-2588.
[11]	P. Desai, P. Patel (2011), “Fibroids, infertility and laparoscopic myomectomy”. J Gynecol Endosc Surg; 2 pp: 36–42.
[12]	A. M. Darwish, A. M Nasr, D. A. El-Nashar, (2005) “Evaluation of postmyomectomy uterine scar”. J Clin Ultrasound; 33: pp. 181–186.
[13]	R. Varma, J. K. Gupta, G. C. S. Smith, (2007) “Birth after previous cesarean birth. Royal College of Obstetricians and Gynaecologists 2007 pp. 1-17.
[14]	G. Saade, M. A. Belfort, M. R. Foley, J. P Phelan, G. A. Dildy (2010) Etiology and Management of Hemorrhage. In: Stafford I, Belfort MA, GAD III, Critical Care Obstetrics. John Wiley & Sons, pp. 310-312.
[15]	Y. Zhang, K. Q. Hua “Patients' age, myoma size, myoma location, and interval between myomectomy and pregnancy may influence the pregnancy rate and live birth rate after myomectomy”. J Laparoendosc Adv Surg Tech 2014 A 24: PP. 95-99. Online: Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935437/Accessed 5 August 2020.

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Innocent Anayochukwu Ugwu, Boniface Uwaezuoke Odugu, Celestine Chukwudi Obiora, Perpetua Kelechi Enyinna, Chude Chukwuka Eze, et al. (2020). Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World Journal of Medical Case Reports, 1(1), 5-8. https://doi.org/10.11648/j.wjmcr.20200101.12

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ACS Style

Innocent Anayochukwu Ugwu; Boniface Uwaezuoke Odugu; Celestine Chukwudi Obiora; Perpetua Kelechi Enyinna; Chude Chukwuka Eze, et al. Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World J. Med. Case Rep. 2020, 1(1), 5-8. doi: 10.11648/j.wjmcr.20200101.12

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AMA Style

Innocent Anayochukwu Ugwu, Boniface Uwaezuoke Odugu, Celestine Chukwudi Obiora, Perpetua Kelechi Enyinna, Chude Chukwuka Eze, et al. Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World J Med Case Rep. 2020;1(1):5-8. doi: 10.11648/j.wjmcr.20200101.12

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@article{10.11648/j.wjmcr.20200101.12,
  author = {Innocent Anayochukwu Ugwu and Boniface Uwaezuoke Odugu and Celestine Chukwudi Obiora and Perpetua Kelechi Enyinna and Chude Chukwuka Eze and Innocent Igwebueze Okafor},
  title = {Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report},
  journal = {World Journal of Medical Case Reports},
  volume = {1},
  number = {1},
  pages = {5-8},
  doi = {10.11648/j.wjmcr.20200101.12},
  url = {https://doi.org/10.11648/j.wjmcr.20200101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20200101.12},
  abstract = {Uterine inversion which commonly occurs during the puerperium is the descent of the fundus of the uterus into or through the cervix thereby keeping the uterus in an ‘inside out’ position. Other structures such as the ovaries and fallopian tubes may also be displaced from the pelvis and restricted within the inverted uterus. However, non puerperal uterine inversion is very rare and represents about one-sixth of all inversion. The most common implicating factor in non-puerperal inversion is prolapsed fibroid with occasional reports of endometrial polyp and uterine neoplasia. Diagnosis of non-puerperal uterine in version may pose a major problem and treatment in women of reproductive age who desire future fertility may involve conservative surgeries. Case Report: We report a case of a 35 year old nulliparous woman with complaints of sudden protrusion of a mass from her vagina with associated cramping lower abdominal pain and vaginal bleeding. A diagnosis of non puerperal uterine inversion due to sub mucous uterine fibroid was made. Surgical interventions done included excision of fibroid and rectification of the uterus through Haultain’s procedure. Histology confirmed uterine fibroid and patient had resumed normal menstrual flow. Conclusion: High index of suspicion is essential for proper diagnosis of non-puerperal uterine in version. In the setting of fertility sparing surgeries, malignancy need to be ruled out, and the woman must be counseled on interval to next pregnancy and risks associated with different modes of delivery.},
 year = {2020}
}

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TY  - JOUR
T1  - Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report
AU  - Innocent Anayochukwu Ugwu
AU  - Boniface Uwaezuoke Odugu
AU  - Celestine Chukwudi Obiora
AU  - Perpetua Kelechi Enyinna
AU  - Chude Chukwuka Eze
AU  - Innocent Igwebueze Okafor
Y1  - 2020/09/07
PY  - 2020
N1  - https://doi.org/10.11648/j.wjmcr.20200101.12
DO  - 10.11648/j.wjmcr.20200101.12
T2  - World Journal of Medical Case Reports
JF  - World Journal of Medical Case Reports
JO  - World Journal of Medical Case Reports
SP  - 5
EP  - 8
PB  - Science Publishing Group
SN  - 2994-726X
UR  - https://doi.org/10.11648/j.wjmcr.20200101.12
AB  - Uterine inversion which commonly occurs during the puerperium is the descent of the fundus of the uterus into or through the cervix thereby keeping the uterus in an ‘inside out’ position. Other structures such as the ovaries and fallopian tubes may also be displaced from the pelvis and restricted within the inverted uterus. However, non puerperal uterine inversion is very rare and represents about one-sixth of all inversion. The most common implicating factor in non-puerperal inversion is prolapsed fibroid with occasional reports of endometrial polyp and uterine neoplasia. Diagnosis of non-puerperal uterine in version may pose a major problem and treatment in women of reproductive age who desire future fertility may involve conservative surgeries. Case Report: We report a case of a 35 year old nulliparous woman with complaints of sudden protrusion of a mass from her vagina with associated cramping lower abdominal pain and vaginal bleeding. A diagnosis of non puerperal uterine inversion due to sub mucous uterine fibroid was made. Surgical interventions done included excision of fibroid and rectification of the uterus through Haultain’s procedure. Histology confirmed uterine fibroid and patient had resumed normal menstrual flow. Conclusion: High index of suspicion is essential for proper diagnosis of non-puerperal uterine in version. In the setting of fertility sparing surgeries, malignancy need to be ruled out, and the woman must be counseled on interval to next pregnancy and risks associated with different modes of delivery.
VL  - 1
IS  - 1
ER  -

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Author Information

Innocent Anayochukwu Ugwu

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
Boniface Uwaezuoke Odugu

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
Celestine Chukwudi Obiora

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
Perpetua Kelechi Enyinna

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
Chude Chukwuka Eze

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria
Innocent Igwebueze Okafor

Department of Obstetrics and Gynaecology, College of Medicine, Enugu State University of Science and Technology (ESUT) and ESUT Teaching Hospital, Enugu, Nigeria

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APA Style

Innocent Anayochukwu Ugwu, Boniface Uwaezuoke Odugu, Celestine Chukwudi Obiora, Perpetua Kelechi Enyinna, Chude Chukwuka Eze, et al. (2020). Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World Journal of Medical Case Reports, 1(1), 5-8. https://doi.org/10.11648/j.wjmcr.20200101.12

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ACS Style

Innocent Anayochukwu Ugwu; Boniface Uwaezuoke Odugu; Celestine Chukwudi Obiora; Perpetua Kelechi Enyinna; Chude Chukwuka Eze, et al. Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World J. Med. Case Rep. 2020, 1(1), 5-8. doi: 10.11648/j.wjmcr.20200101.12

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AMA Style

Innocent Anayochukwu Ugwu, Boniface Uwaezuoke Odugu, Celestine Chukwudi Obiora, Perpetua Kelechi Enyinna, Chude Chukwuka Eze, et al. Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report. World J Med Case Rep. 2020;1(1):5-8. doi: 10.11648/j.wjmcr.20200101.12

Copy | Download

@article{10.11648/j.wjmcr.20200101.12,
  author = {Innocent Anayochukwu Ugwu and Boniface Uwaezuoke Odugu and Celestine Chukwudi Obiora and Perpetua Kelechi Enyinna and Chude Chukwuka Eze and Innocent Igwebueze Okafor},
  title = {Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report},
  journal = {World Journal of Medical Case Reports},
  volume = {1},
  number = {1},
  pages = {5-8},
  doi = {10.11648/j.wjmcr.20200101.12},
  url = {https://doi.org/10.11648/j.wjmcr.20200101.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.wjmcr.20200101.12},
  abstract = {Uterine inversion which commonly occurs during the puerperium is the descent of the fundus of the uterus into or through the cervix thereby keeping the uterus in an ‘inside out’ position. Other structures such as the ovaries and fallopian tubes may also be displaced from the pelvis and restricted within the inverted uterus. However, non puerperal uterine inversion is very rare and represents about one-sixth of all inversion. The most common implicating factor in non-puerperal inversion is prolapsed fibroid with occasional reports of endometrial polyp and uterine neoplasia. Diagnosis of non-puerperal uterine in version may pose a major problem and treatment in women of reproductive age who desire future fertility may involve conservative surgeries. Case Report: We report a case of a 35 year old nulliparous woman with complaints of sudden protrusion of a mass from her vagina with associated cramping lower abdominal pain and vaginal bleeding. A diagnosis of non puerperal uterine inversion due to sub mucous uterine fibroid was made. Surgical interventions done included excision of fibroid and rectification of the uterus through Haultain’s procedure. Histology confirmed uterine fibroid and patient had resumed normal menstrual flow. Conclusion: High index of suspicion is essential for proper diagnosis of non-puerperal uterine in version. In the setting of fertility sparing surgeries, malignancy need to be ruled out, and the woman must be counseled on interval to next pregnancy and risks associated with different modes of delivery.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Complete Non-puerperal Uterine Inversion in a Nulliparous Woman Due to Sub Mucous Fibroid – A Case Report
AU  - Innocent Anayochukwu Ugwu
AU  - Boniface Uwaezuoke Odugu
AU  - Celestine Chukwudi Obiora
AU  - Perpetua Kelechi Enyinna
AU  - Chude Chukwuka Eze
AU  - Innocent Igwebueze Okafor
Y1  - 2020/09/07
PY  - 2020
N1  - https://doi.org/10.11648/j.wjmcr.20200101.12
DO  - 10.11648/j.wjmcr.20200101.12
T2  - World Journal of Medical Case Reports
JF  - World Journal of Medical Case Reports
JO  - World Journal of Medical Case Reports
SP  - 5
EP  - 8
PB  - Science Publishing Group
SN  - 2994-726X
UR  - https://doi.org/10.11648/j.wjmcr.20200101.12
AB  - Uterine inversion which commonly occurs during the puerperium is the descent of the fundus of the uterus into or through the cervix thereby keeping the uterus in an ‘inside out’ position. Other structures such as the ovaries and fallopian tubes may also be displaced from the pelvis and restricted within the inverted uterus. However, non puerperal uterine inversion is very rare and represents about one-sixth of all inversion. The most common implicating factor in non-puerperal inversion is prolapsed fibroid with occasional reports of endometrial polyp and uterine neoplasia. Diagnosis of non-puerperal uterine in version may pose a major problem and treatment in women of reproductive age who desire future fertility may involve conservative surgeries. Case Report: We report a case of a 35 year old nulliparous woman with complaints of sudden protrusion of a mass from her vagina with associated cramping lower abdominal pain and vaginal bleeding. A diagnosis of non puerperal uterine inversion due to sub mucous uterine fibroid was made. Surgical interventions done included excision of fibroid and rectification of the uterus through Haultain’s procedure. Histology confirmed uterine fibroid and patient had resumed normal menstrual flow. Conclusion: High index of suspicion is essential for proper diagnosis of non-puerperal uterine in version. In the setting of fertility sparing surgeries, malignancy need to be ruled out, and the woman must be counseled on interval to next pregnancy and risks associated with different modes of delivery.
VL  - 1
IS  - 1
ER  -

Copy | Download