Uterine inversion: systematic review

Abstract

This study addresses uterine inversion, a rare obstetric complication that can occur in both puerperal and non-puerperal contexts, requiring timely clinical management to reduce maternal morbidity and mortality. The aim of this study is to determine the current evidence on the incidence, clinical management, and maternal outcomes in cases of uterine inversion through a systematic review in the PubMed database, according to the PRISMA 2020 methodology, in the period from January 2020 to January 2025. A bibliographic search was conducted using a predefined algorithm that included studies published during this period, and rigorous inclusion and exclusion criteria were applied to select relevant evidence. The results indicate that, despite its low incidence, uterine inversion represents a diagnostic and therapeutic challenge, given its presentation can vary between puerperal and non-puerperal forms and is associated with conditions such as submucosal fibroids and other uterine pathologies. Additionally, the heterogeneity in management methods is highlighted, with interventions ranging from manual repositioning to complex surgical techniques being reported, emphasizing the need for early diagnosis through imaging tools and a multidisciplinary approach. In conclusion, the systematic review evidences that updating diagnostic and therapeutic strategies is crucial for optimizing the management of uterine inversion and improving maternal outcomes, providing a solid foundation for future clinical recommendations.