Grades of inversion Uterine inversion is defined by the severity of the inversion. These categories include: incomplete inversion, in which the top of the uterus has collapsed, but none of the uterus has come through the cervix complete inversion, in which the uterus is inside out and comes out the cervix prolapsed inversion, in which the top of the uterus is coming out of the vagina total inversion, in which both the uterus and the vagina are inside out How do you treat a uterine inversion? Treatment should begin as soon as uterine inversion is recognized. The doctor may be able to push the top of the uterus back into the pelvis through the dilated cervix. General anesthesia, such as halothane Fluothane gas, or medications such as magnesium sulfate, nitroglycerin, or terbutaline may be required. Once the uterus is repositioned, oxytocin Pitocin and methylergonovine Methergine are given to help the uterus contract and prevent it from inverting again.
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What you need to know for future pregnancies What is a uterine inversion? Uterine inversion is a serious but rare complication of childbirth in which the uterus literally turns inside out after the baby is delivered. When this happens, the top of the uterus the fundus comes through the cervix or even completely outside the vagina. It occurs in about 1 in 3, births.
Normally, after a vaginal birth, contractions cause the placenta to separate from the wall of the uterus. This typically happens within five to ten minutes after you give birth, though it may take longer. After your caregiver sees signs that the placenta is separating, she may ask you to gently push to help expel the placenta out of your uterus and through the vagina. She may help guide the placenta out of the vagina by gently pulling on the umbilical cord.
How is it treated? Your doctor or midwife will try to reposition your uterus and push the fundus back through the cervix. Occasionally, abdominal surgery is necessary to return the uterus to its original position. Once your uterus has been repositioned, the drugs that were used to relax the uterus will be stopped.
Until your uterus firms up, your caregiver will apply pressure to it with one hand inside your vagina and the other on your belly to compress the uterus and slow the bleeding. Your medical team will continue to watch you closely. Make sure you get lots of rest, eat nutritious meals, drink plenty of fluids, and follow any other instructions from your caregiver to the letter. As with any pregnancy complication or other medical problem, be sure your doctor or midwife is aware of your history.
This gives your caregiver a chance to prepare for the possibility of another inversion by making sure you have an IV running and an anesthesiologist immediately available, if needed, for your delivery.
Show sources Gupta P, et al. Acute uterine inversion: A simple modification of hydrostatic method of treatment. Annals of Medical and Health Sciences Research 4 2 Uterine inversion. Journal of the American Board of Family Medicine 17 2 Inverted uterus. Total and acute uterine inversion after delivery: A case report. Journal of Medical Case Reports Puerperal uterine inversion.
Pregnancy Complications: Uterine Inversion