Uterine Inversion

Uterine inversion is a postpartum structural emergency: the uterine fundus collapses inward and may descend through the cervix into the vagina. The fastest recognition pattern is sudden bleeding plus an absent or displaced abdominal fundus, severe pelvic pain, syncope, or a red-purple vaginal mass. Treat this combination as inversion until the obstetric team proves otherwise. Call emergency help, support circulation, avoid traction or placental removal, and prepare for immediate Johnson/manual reduction; routine fundal massage is the wrong response when the fundus is inverted.