Uterus, as we know, is the reproductive organ positioned in the female pelvis between the bladder and rectum. The ovaries release eggs that travel through the fallopian tubes and then implant themselves in the inner lining of the uterus upon getting fertilized. The foremost and prime function of the uterus is to feed the growing fetus prior to childbirth. As a matter of fact, there's nothing wrong in having a uterus that is inverted, as it is just a different version of how the nature has created you.
What is an Inverted Uterus?
➜ An inverted uterus is a naturally-occurring variance on how the uterus is positioned in the lower abdomen of a woman. Basically, the uterus, instead of lying on top of the bladder, is positioned on either side of it. As a result, it heads back towards the spinal column instead of the belly button.
➜ The cervix (or the opening of the uterus) remains intact at the same place, i.e., either at the top part or end of the vaginal canal, but the body (or fundus) of the uterus lies in an unusual position. Medically termed as retroverted uterus, tipped uterus, or malposition of the uterus, women with this abnormality usually have no problems with regards to conception and childbirth.
➜ Hence, the myth that women having an inverted uterus can not have children is totally false, because once they conceive, the uterus gradually comes back to its normal position until the baby is born. Thereafter, it becomes inverted again.
Causes can be genetic, naturally occurring, or due to the shift in the positioning of the uterus during a complicated pregnancy. Mentioned below are a few circumstances that can lead to such a condition:
► Pulling on the Cord with no Contraction
If the midwife or doctor tries to deliver the placenta while the uterus is relaxed and the placenta is still connected to it, the uterus can get pulled down and inverted.
► Pushing on the Top of the Uterus when the Uterus is Relaxed
Forceful or emphatic pushing on the woman's belly and on top of the uterus when there's no contraction can also lead to a tipped uterus.
► Partial Separation of the Placenta
Quite often, only a part of the placenta separates and as the midwife or doctor tries to deliver the placenta, because the bleeding has started to indicate the placenta is separating, the uterus will be pulled down with the part of the placenta that is still attached. Hence, it will get inverted.
► Pulling the Attached Placenta Down during an MROP
During an MROP, i.e., manual removal of placenta, if the placenta is reluctant to separate and is retained inside the uterus, the midwife may try to remove it manually, i.e., with the help of the hands. Forcing the placenta down, that has not easily separated, can at times bring the top of the uterus down with it.
Although there are no specific symptoms to detect a retroverted uterus, pain or uneasiness especially during sex and menstruation (which is also very rare) can be observed in women. Besides this, a slight side effect is an extra discomfort, bleeding, and shear pain during childbirth. Also, it may cause additional complications during childbirth in teenage pregnancies.
➜ A pelvic examination and an ultrasound examination are the 2 tests that can help in the diagnosis. Since it doesn't have any severe side effects, usually there's no need to treat a malposition of the uterus.
➜ However, treatment is based on manual reduction in which the uterus is returned to its normal position by pushing up on the fundus. If the placenta is still attached, then the uterus has to be repositioned before the placenta is removed.
➜ Terbutaline 0.25 mg IV or nitroglycerin 50 μg IV sedatives or a general anesthesia is sometimes needed to subside the discomfort and pain. If this method doesn't work, a laparotomy may be done in which the fundus is manipulated vaginally and abdominally to return it to its actual position.
➜ After it has been replaced, an oxytocin infusion (hormone secreted by the posterior pituitary gland that stimulates contractions of the uterus) should be started.
Medically, it has not been proven yet that an inverted uterus can cause any severe harm to the person or can lead to any life-threatening disease or complication within the body's functionality. However, if you or someone close to you has been diagnosed with this condition, don't panic and consult your doctor as he/she can give the correct information about the size and configuration of the uterus and whether or not it will affect your health in any way.
Disclaimer: This HerHaleness article is for informative purposes only and should not be used as a replacement for expert medical advice.