What is the medical management for uterine inversion?

What is the medical management for uterine inversion?

Uterine inversion means the placenta fails to detach from the uterine wall, and pulls the uterus inside-out as it exits. Treatment options depend on the severity, but could include reinserting the uterus by hand, abdominal surgery or emergency hysterectomy.

How is uterine inversion replaced?

The recent uterine inversion with the placenta already separated from it may often be replaced by manually pushing up on the fundus with the palm and fingers in the direction of the long axis of the vagina. A delay will render replacement more difficult and also increase the risk of hemorrhage.

What is uterine inversion?

INTRODUCTION Uterine inversion occurs when the uterine fundus collapses into the endometrial cavity, turning the uterus partially or completely inside out. It is a rare complication of vaginal or cesarean delivery, but when it occurs, it is a life-threatening obstetric emergency.

What is the most common cause of uterine inversion?

Causes. The most common cause is the mismanagement of 3rd stage of labor, such as: Fundal pressure. Excess cord traction during the 3rd stage of labor.

What are the primary presenting signs of uterine inversion?

Acute Uterine Inversion typically presents with postpartum hemorrhage, shock, abdominal pain, a non-palpable uterine fundus, and a mass on bimanual exam.

What is acute puerperal uterine inversion?

Puerperal uterine inversion is a rare condition; however, once it develops, massive hemorrhage from the surface of the detached placenta or massive atonic hemorrhage occurs, which may result in hemorrhagic shock. Thus, uterine inversion is a serious condition that could result in maternal death if not treated urgently.

Can you get pregnant after a uterine inversion?

Puerperal inversion of the uterus is itself a rare occurrence. Records of fertility and reproduction following an episode of uterine inversion are even rarer. The reproductive outcome following correction of uterine inversion in 6 cases seen over a span of 35 years is being reported here.

Can you have another baby after a uterine inversion?

What you need to know for future pregnancies. Once you’ve had one uterine inversion, you’re more likely to have another one. As with any pregnancy complication or other medical problem, be sure your doctor or midwife is aware of your history.

What are the effective prevention measures of uterine inversion?

General anesthesia, such as halothane (Fluothane) gas, or medications such as magnesium sulfate, nitroglycerin, or terbutaline may be required. Once the uterus is repositioned, oxytocin (Pitocin) and methylergonovine (Methergine) are given to help the uterus contract and prevent it from inverting again.

How many degrees of uterine inversion are there?

Uterine inversion can be classified in four degrees, depending on the localization of the uterine fundus. In the 1st degree, the fundus is inside the cavity. If it reaches but does not exceed the cervical external os, it is a 2nd degree inversion.

When does Lochia rubra stop?

The lochia rubra phase typically lasts for seven days or so. If bleeding during this time is excessively heavy or continues beyond two weeks after you’ve delivered your baby, let your OB-GYN or caregiver know.

Can an inverted uterus cause infertility?

Does having a tilted uterus make it more difficult to conceive? Answer From Yvonne Butler Tobah, M.D. A tilted uterus, also called a tipped uterus, retroverted uterus or retroflexed uterus, is a normal anatomical variation. It shouldn’t interfere with your ability to conceive.

How do you classify Uterine inversion?

The classification systems of uterine inversion are based on either the duration or magnitude of the inversion. Criteria are found in Table 31-1, and examples are seen in Figures 31-1 and 31-2 (Kitchin, 1975; Livingston, 2007; Pauleta, 2010; Watson, 1980; You, 2006).

Is hydrostatic method effective in reducing acute puerperal Uterine inversion?

Background: Hydrostatic method for reducing acute uterine inversion is simple method, if advocated properly. Aim:The aim of this study is to reduce the failures in technique in O’Sullivan’s method in acute puerperal uterine inversion hence reducing maternal mortality and morbidity.

How is the Johnson maneuver used to replace the uterus?

Manual replacement of the uterus, termed the Johnson maneuver, involves pushing the inverted fundus toward the umbilicus. With an inversion after vaginal delivery, the fundus is elevated through the contracted myometrial ring, which forms at the upper cervix, to restore normal positioning (Figs. 31-4 and 31-5) (Johnson, 1949).

What are the risks of inversion during cesarean delivery?

Second, inversion during cesarean delivery is typically recognized and managed more expediently than at vaginal delivery. Accordingly, rates of significant clinical complications such as severe hemorrhage and blood transfusion are lower (Baskett, 2002; Terp, 1998).