A 32-year-old woman at 39 weeks with no prior uterine surgery is admitted in active labor. She has an uncomplicated vaginal delivery followed by a gush of blood and a visible hourglass-shaped uterus with a fundal dimple on palpation. The MOST likely diagnosis is:
- A Retained placental tissue
- B Uterine rupture
- C Uterine inversion ✓
- D Broad ligament hematoma
Correct answer: C. Uterine inversion
Explanation
Acute uterine inversion presents with a gush of blood, severe pain, and a palpable fundal dimple or visible hourglass uterus at the introitus or lower uterine segment. It is a life-threatening obstetric emergency requiring immediate repositioning. Uterine rupture shows abdominal pain and fetal distress, not a fundal dimble. Retained placenta does not cause this sign.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.