Acute uterine inversion complicating mid-trimester unsafe abortion in a teenage Nigerian girl

Abstract

Uterine inversion is a rare but life-threatening obstetric emergency, complicating 1 in 2,000 to 1 in 50,000 deliveries. Very rarely, this condition also complicates unsafe abortion. A case of acute complete (fourth-degree) uterine inversion, with gangrene of the uterus in an 18-year-old nulliparous girl who presented to the Gynaecologic Emergency Unit of the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria, in hypovolemic shock from massive haemorrhage following unsafe mid-trimester termination of unwanted pregnancy is reported. She was adequately resuscitated, and a vaginal hysterectomy was performed. The patient was discharged following an uneventful postoperative period. This case highlights the consequences of the high unmet need for family planning and the restrictive abortion laws in Nigeria, limiting access to effective contraception and safe abortion services, thereby increasing the risk of maternal mortality and morbidity from complications of unsafe abortion.