Obs Emergencies - Acute Uterine Inversion

Question 1

What is acute uterine inversion?

Answer 1

The uterus turns inside out following childbirth protruding down into the vagina.

associated with fundal placenta.

Question 2

What are the symptoms of acute uterine inversion?

Answer 2

1. appears as a bluish-grey mass protruding from the vagina
2. vital sign changes - low blood pressure
3. postpartum bleeding
4. placenta is often still attached

Question 3

What are the risk factors for acute uterine inversion?

Answer 3

Pulling on the umbilical cord or pushing on the top of the uterus before the placenta has detached, uterine atony, placenta previa, connective tissue disorders[1]

Diagnosis - seeing the inside of the uterus in the vagina

Question 4

What is the management of acute uterine inversion?

Answer 4

1. call for help ABCDE resuscitation
2. rapidly replace the uterus
3. once reverted, uterotonic agents should be given to promote uterine tone and prevent recurrence i.e. oxytocin