Uterine Inversion

Question 1

What is uterine inversion?

Answer 1

Fundus of the uterus descends through the cervix (uterus turns inside out)

Question 2

Incomplete vs complete uterine inversion

Answer 2

Incomplete = fundus up to the level of the introitus

Complete = fundus passes through the introitus

Question 3

Iatrogenic cause of uterine inversion?

Answer 3

Too much traction during active management of the third stage of labour

Question 4

Complication of uterine inversion

Answer 4

Cause a massive PPH (the uterus cannot tamponade if it is inverted)

Question 5

Initial management of uterine inversion

Answer 5

Johnson manoeuvre - manually pushing the uterus back into place and holding it there for a long time

Question 6

Management of uterine inversion if the Johnson manoeuvre fails

Answer 6

Hydrostatic management (the uterus and vagina are filled with fluid in an attempt to push the uterus back into its anatomical position)

Question 7

Management of uterine inversion if hydrostatic management fails

Answer 7

Surgical correction of uterine inversion during laparoscopy