Flashcards in Uterine Inversion Deck (11)
Most common cause uterine inversion?
Undue traction of the cord before placental separation
Four signs of placental separation?
1. Gushing blood
2. Lengthening of the cord
3. Globular and firm shape of the uterus
4. Uterus rises up to anterior abdominal wall
Abnormally retained placenta?
Third stage of labor that has exceeded 30 minutes
Fundus of the uterus moves through the cervix into the vagina
Patient at particular risk of uterine inversion?
Grand-multiparous patient with placenta attached to fundus
Patient with inverted uterus – treatment?
1. Two large bore IV lines
2. Uterine relaxation – halothane
3. If placenta has separated, manual replacement of uterus
4. Terbutaline or magnesium sulfate to relax uterus (if necessary)
5. Once in normal location, uterotonic agents (oxytocin)
Patient with an abnormally retained placenta – next step?
Manual extraction attempt
Point of giving oxytocin?
Allows uterus to contract down on itself, stopping bleeding
Inaccessible inverted uterus, next step?
Uterine relaxing agent (halothane) >terbutaline/magnesium sulfate
Why does inverted uterus cause hemorrhage?
Unable to contract, therefore unable to temper bleeding