9.18 Uterine Inversion

Question 1

Where does the uterus pass through in a uterine inversion?

Answer 1

fungus of the uterus pass through the cervix.

very rare emergency, can be from pulling too hard on the cord

Question 2

What is an incomplete uterine inversion vs a complete inversion?

Answer 2

incomplete - past cervix but not introitus

complete - through vagina to the introitus

(both have PPH, shock, collapse)

Question 3

What are the three options for managing a uterine inversion?

Answer 3

• Johnson manoeuvre
• hydrostatic methods
• surgery (laparotomy and return uterus to place)

Question 4

What is involved in the Johnson manoeuvre?

Answer 4

For uterine inversion:

• hand and arm is used to push uterus back into place
• hand kept there for several minutes and oxytocin infusion started

Question 5

What does hydrostatic methods for uterine inversion involve?

Answer 5

create a seal around the vagina and inflate the uterus with water to return it do its shape (if Johnson manoeuvre has failed)