In the article we will consider such a pathology as an everted uterus.
This is the main reproductive organ of a woman. It is located in the lower pelvis. When her eversion happens, this indicates that some layer of the organ partially or completely protrudes beyond the small pelvis. Such a disease is diagnosed quite rarely, but there are a number of signs by which pathology can be determined. And treatment should be started immediately and only by a trusted, qualified gynecologist.
Basic concept
Uterine eversion is a severe and life-threatening obstetric complication that occurs in one case in 400,000 births. Inversion of the uterus is called the depression of the fundus of the uterus from the side of the abdomen and chest inward until the entire uterus is everted through the cervix with the mucous membrane outward. In this case, the uterus descends into the vagina, and a deep funnel is formed inside the abdominal cavity, which is lined with a serous layer. Fallopian tubes, uterine ligaments and ovaries are drawn into it.
Invertedthe uterus can occur when the groups of tissues and muscles that support the pelvic organs are weakened. In case of sagging of these organs, the upper part of the uterus prolapses. A woman may experience both the sagging of the uterus to the upper part of the vagina (this is considered the first degree of the disease), and the prolapse of the uterus up to 10 cm, which will lead to her falling out of the body.
Most often, uterine inversion is associated with improper labor, it is dangerous for a woman and requires immediate elimination.
Cause of disease
Reversed uterus can be caused by:
- atony, when there is no muscle tension of the organ after childbirth, which is especially evident during coughing, sneezing, pressure on the stomach;
- premature pulling of the umbilical cord when the placenta has not yet separated;
- rough conduct by the doctor of labor, when the placenta is strongly pressed on the uterus to separate the placenta;
- removal of polyps or fibroids with short knives.
The factors of spontaneous eversion are also determined:
- attachment of the placenta to the bottom of the uterus;
- presence of a large myomatous node in the area of its bottom.
Symptoms
Symptomatology of everted cervix appears:
- bloody discharge from the genital tract is bright red with large blood clots.
- pallor of the skin and mucous membranes, the patient shows cold sweat;
- sharp intense pain in the lower abdomen, sacrum.
- possible loss of consciousness;
- drop in blood pressure with barely perceptible pulse;
- the presence of a red mucus formation inside the vagina.
These manifestations should not go unnoticed.
Shapes
To the inverted uterus can lead to her relaxed state, with a simultaneous increase in pressure in the intra-abdominal region. This is called spontaneous eversion. Violent occurs in cases of early stretching of the umbilical cord and rough pressure on the uterus.
Distinguish between complete and incomplete eversion:
- With incomplete eversion, the fundus of the uterus does not cross the limits of the internal os.
- When full, the uterus and vagina turn outward, outside the genital slit. Depending on the time of occurrence, the disease is characterized as acute or chronic. The first form occurs during childbirth or immediately after them, the second develops slowly, aggravates a few days after childbirth.
Inverted uterus after childbirth
With a weak muscular apparatus of the pelvic organs and birth injuries, uterine inversion occurs. Most of the time, this is what causes breaks. Thrush can also provoke this, since under the influence of this infection, muscle tissue is corroded, which makes them thinner and weaker, so they themselves can tear during childbirth. Torn areas are sometimes difficult to sew up, and scars heal very poorly and take a long time.
In some cases, obstetric forceps are used during childbirth, which alsoeasily injure weakened tissues.
To maintain them in an elastic form, the female body needs estrogens. With age, the level of the hormone of youth decreases, which leads to a loss of former elasticity, the tissues become thin, just at this time, women most often face the problem of uterine prolapse.
Can the uterus be inverted outside of labor?
Cause of illness outside of childbirth
Such an unpleasant situation can occur and not only in the process of childbirth. A woman who has a history of a number of gynecological problems may encounter a similar pathology. This can also happen after heavy physical exertion, which is extremely dangerous, she may experience severe bleeding and a state of shock. She should be rushed to a hospital for emergency care as soon as possible.
In the presence of tumors of the uterus, organ eversion is also possible. In this case, the symptoms of this condition will gradually increase, the woman herself may not notice what happened, and, most likely, she will seek medical help only after a few days.
In any case, the woman is hospitalized. Her treatment will depend on her age, on the time the uterus stays in an everted state. In case of complete prolapse of the organ, it is wrapped in a sterile bandage.
Diagnosis
Diagnosis of everted cervical mucosa can only be carried out by a gynecologist. First of all, the patient is asked: when and what kind of discharge appeared, what is their volume, are there any pain sensationsin the lower abdomen, whether there were surgical interventions or labor activity.
Next, obstetric and gynecological information is collected: possible gynecological diseases that have been transferred early, pregnancies, what kind of childbirth, the peculiarity and outcome of childbirth, the course of the last pregnancy.
The attending physician examines the woman, measures her blood pressure, pulse, feels her stomach and uterus. With an external examination, the doctor determines the size of the organ, shape and tension. Next, an examination is carried out on a special chair. The doctor, inserting one hand into the vagina, palpates the uterus itself, its ligaments and ovaries, and holds the other hand on the patient's stomach. Also, to determine the exact picture, the doctor examines the cervix in special medical mirrors.
Treatment
There is a manual method for eliminating pathology, that is, returning the organ to its place. The doctor presses with his hand on the bottom of the uterus, returning it back. If this happens during childbirth, he first manually separates the placenta from its walls. Doctors consider this method dangerous because of the possibility of shock and infectious complications. The most commonly used conservative treatment of uterine inversion, which is used:
- Cholinomimetics that act on the cervix to keep it from contracting.
- Antiseptic drugs are used to prevent the growth of bacteria, they wash the uterine cavity.
- Aqueous and colloidal solutions to increase blood pressure are usedintravenously.
During surgical treatment, a colpohysterotomy is performed, when an incision is made on the back wall of the vagina and uterus, it is set in place, then the defect is sutured. This method is used if manual reduction is not possible. If more than 24 hours have passed since the prolapse of the uterus, then it is removed. After successful reduction of the uterus, tamponade is required, broad-spectrum antibacterial drugs are prescribed, and the cavity is treated with an antiseptic solution. After the patient, a cold and heavy heating pad is placed on the lower abdomen. It is necessary to limit the movement of the patient in the first hours after the procedure, her position should be strictly horizontal, her legs should be slightly raised.
What is the danger of an everted uterus in a woman?
Possible complications and consequences
In medical practice, they face the following complications:
- endometritis - inflammation of the mucous layer of the uterus;
- peritonitis;
- sepsis, in which bacteria enter the bloodstream;
- necrosis of the uterus, i.e., death of its sections occurs;
- hemorrhagic shock;
- development of bleeding disorders;
- fatal.
Preventive measures must be taken to prevent this.
Prevention
To prevent an everted uterus in a woman, you should:
- Plan and prepare for pregnancy, detect and treat chronic diseases in time. If athere was an operation on the uterus, then it is better to postpone the planning of conception for two years.
- Timely register for pregnancy at the antenatal clinic.
- See your OB/GYN doctor regularly, at least once a month.
- Eat a rational and balanced diet, pregnant women are advised to give up fatty, very hot and spicy foods, do not eat canned foods.
- Sleep well.
- Take vitamins and sedatives if your doctor recommends.
- Quit smoking, alcohol and drugs.
- Exclude excessive physical and psycho-emotional stress.
Recommended for increased risk of uterine prolapse during childbirth:
- eliminate cord pulling;
- avoid strong pressure on the uterus;
- correctly apply the Krede-Lazarevich technique;
- take drugs to reduce the muscle tissue of the uterus;
- Perform ultrasound examination of the pelvic organs for the timely detection and treatment of neoplasms, polyps and myomatous nodes.
We looked at what it means - the cervix is everted.
