Case 3 - Uterine Inversion

Question 1

Objective

Answer 1

signs of spontaneous placental separation
clinical presentation of uterine inversion

Question 2

What is First stage of Labor, Normal duration?
What is Latent phase?
What is active phase?

What is second stage of Labor? Normal duration?

Answer 2

1st - begin from feeling persistent contraction to cervical fully dilation
usually 12-19 hours
Latent phase 0 - 3 cm (3-8 hours)
Active phase 3-10 cm (2-6 hours)

2nd - lasts from when your cervix is fully dilated until the birth of your baby
can be as fast as 20 mins to few hours

Question 3

What is third stage of labor? normal duration?

Answer 3

From delivery of infant to the delivery of the placenta
(upper limit of normal is 30 minutes).

Question 4

what is signs of placental separation?

Answer 4

Cord lengthening, gush of blood, globular uterine shape, and uterus lifting up to the anterior abdominal wall.

Question 5

Immediate medical assistance of inverted uterus

Answer 5

uterine relaxation anesthetic agent - Halothane
and/ or emergency surgery

If the inversion happened, after placenta separated, the inverted uterus could be replaced by using gloved palm and cupped fingers.

Terbutaline or magnesium sulfate could be utilized to relax the uterus prior to uterine replacement.

Upon replacing the uterine fundus to the normal location, the relaxation agents are stopped, and then uterotonic agents, such as oxytocin, are given.