Multigravida Post-Partum dengan Inversio Uteri Subakut Komplit yang Ditatalaksana Histerektomi Supraservikal Pervaginam

Amir Fauzi, Ratih Krisna, Hadrians Kesuma Putra, Yurizka Sabrina


Abstract


Inversio uteri adalah salah satu komplikasi persalinan dengan risiko kematian tinggi akibat perdarahan dan syok. Laporan ini menjelaskan mengenai presentasi dan manajemen kasus inversio uteri. Seorang wanita berusia 33 tahun, P4A0 post partum spontan di bidan hari ke 5 dirujuk ke RS Mohammad Hoesin dengan riwayat uterus yang ikut keluar saat persalinan, namun uterus dapat dimasukkan kembali. Tanda-tanda vital pasien dalam batas normal. Pada pemeriksaan abdomen didapatkan tinggi fundus uteri sulit dinilai. Pada saat dilakukan inspeksi terdapat benjolan berupa keseluruhan uterus yang terbalik keluar dari serviks. Pemeriksaan laboratorium menunjukkan penurunan kadar hemoglobin (9.1 g/dL) dan peningkatan kadar leukosit (10.34x103/mm2). Pada pemeriksaan USG tidak tampak uterus pada kavum pelvis dengan kesan yang sesuai dengan gambaran inversio komplit. Pasien dipasangkan kateter lalu diputuskan untuk histerektomi supraservikal pervaginam. Kemudian pada pasien dilakukan pemasangan tampon vagina, pemberian antibiotik, antifibrinolitik serta obat simptomatik dengan stabilisasi berupa cairan dan transfusi. Setelah dua hari, tampon dilepas dan pasien membaik tanpa adanya komplikasi.

Post-Partum Multigravida with Complete Subacute Uterus Inversion Treated by Vaginal Supracervical Hysterectomy

Abstract
Uterine inversion is one of labor complications with high mortality risk caused by bleeding and shock. This paper presenting the clinical manifestation and the management of uterine inversion. A 33-year-old woman, P4A0 spontaneous postpartum at midwife day-5 was referred to Mohammad Hoesin Hospital with uterine expulsion during delivery and the uterine could be re-inserted. Vital signs within normal limits. Abdominal examination showed unmeasurable uterine fundal height. Gyneclogical examination showed an inverted uterus mass outside the cervix. There was decreased haemoglobin (9.1 g/dL) and increased leucocytes (10.34x103/mm2) level. Ultrasonography measure showed no visible uterus in pelvic cavity with impression of complete uterine inversion. The patient was catheterized and decided for vaginal supracervical hysterectomy. The patient applied with vaginal tampons and prescribed with antibiotics, antifibrinolytics and symptomatic drugs with stabilization using crystaloid fluid and blood transfusion. After two days, the tampon was removed and patient improved without any complications.

Key words: hysterectomy, uterine inversion, supracervical


Keywords


hysterectomy, uterine inversion, supracervical

Full Text:

PDF

References


Wendel MP, Shnaekel KL, Magann EF. Uterine inversion: a review of a life-threatening obstetrical emergency. Obstet Gynecol Surv. 2018;73(7):411–7.

Mishra S. Chronic uterine inversion following mid-trimester abortion. J Obstetr Gynecol India. 2018;68(4):320–2.

WHO. World Health Organisation, Managing complications in pregnancy and childbirth: a guide for midwives and doctors: World Health Organization; 2017.

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.

Owaraganise A, Tibaijuka L, Ngonzi J. Subacute uterine inversion following an induced abortion in a teenage girl: a case report. Owaraganise et al. BMC Women's Health.2020. 20:220

Kochenour NK. Diagnosis and Management Of Uterine Inversion. In: Gilstrap LC, Cunningham FG, Vandorsten JP, editors. Operative Obstetrics. 2nd ed. USA: McGraw-Hill Companies;2002.

Wilczyński M, Cieślak J, Malinowski A. Supracervical hysterectomy – the vaginal route. Videosurgery Miniinv 2014; 9 (2): 207–212

Cunningham, F.G, Leveno, K.J, Bloom, S.L, dkk (Editors). 2018. Williams Obstetrics. 25th Edition. United States of America: McGraw-Hill Education.

Hoffman, B.L, Schorge, J.O, Bradshaw, K.D, dkk (Editors). 2016. Williams Gynecology. 3rd Edition. United States of America: McGraw-Hill Education.

Carugno J, Fatehi M. Abdominal Hysterectomy. [Updated 2021 Mar 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK564366/




DOI: http://dx.doi.org/10.24198/obgynia.v5i2.335

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


     
     

Creative Commons License
Indonesian Journal of Obstetrics & Gynecology Science is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License
  Web Analytics
  View My Stat