A 28-year-old woman presents with sudden onset severe abdominal pain 24 hours after an uneventful vaginal delivery. On examination the uterine fundus is not palpable per abdomen and a dark red mass is seen protruding from the vagina. She is hypotensive and tachycardic. What is the most likely diagnosis?

• A Inversion of the uterus ✓
• B Uterine rupture
• C Cervical shock
• D Broad ligament hematoma

Explanation

Acute puerperal uterine inversion classically presents with a mass protruding through the cervix, absent fundal palpation, and hemorrhagic shock shortly after delivery. Uterine rupture typically presents intrapartum. Cervical shock is reflex bradycardia without a mass. Broad ligament hematoma presents with lateral pelvic pain and a mass but no vaginal protrusion of the uterus.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.