Complete Uterine Inversion Following Fundal Pressure During Placental Delivery at Home: A Case Report of Massive Postpartum Haemorrhage Requiring Blood Transfusion

Background: Complete uterine inversion is a rare but life-threatening obstetric emergency associated with severe postpartum haemorrhage, haemodynamic instability, and maternal mortality if not recognized and managed promptly. It most commonly occurs during the third stage of labour and may be precipitated by inappropriate obstetric interventions such as excessive cord traction or fundal pressure. Cases occurring after home delivery remain uncommon but carry a high risk of adverse maternal outcomes due to delayed recognition and referral. We report the case of a 30-year-old un-booked multiparous woman who developed complete uterine inversion following the application of fundal pressure during placental delivery at a home birth attended by an unskilled birth attendant. She presented to our facility with profuse vaginal bleeding, severe lower abdominal pain, haemodynamic instability, and a protruding uterine mass consistent with complete uterine inversion. Following prompt resuscitation with intravenous fluids, uterotonics after uterine replacement, and three (3) units of compatible whole blood, successful manual repositioning of the uterus was achieved using the Johnson's technique. The patient recovered without major complications and was discharged home in stable condition on the fourth post-admission day. Other techniques that can be used if Manual replacement fails are Huntington's/O'Sullivan's techniques.