Complications of pregnancy: Uterine inversion | Health line



Overview


A uterine inversion is a rare complication of vaginal delivery in which the uterus partially or completely reverts.


Although a uterine inversion does not occur frequently, when it does, there is a high risk of death due to severe hemorrhage and shock. However, it can be successfully treated with a rapid diagnosis, intravenous fluids and a blood transfusion.


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What causes a uterine inversion?


The exact cause of uterine inversion is not well understood. However, the following risk factors are associated with it:



  • Work that lasts more than 24 hours.

  • a short umbilical cord

  • previous deliveries

  • Use of muscle relaxants during labor.

  • abnormal or weak uterus

  • previous uterine inversion

  • placenta accreta, in which the placenta is too deeply embedded in the uterine wall

  • Background implant of the placenta, in which the placenta is implanted in the upper part of the uterus.


In addition, pulling too hard on the umbilical cord to remove the placenta can cause a uterine inversion. The umbilical cord should never be pulled hard. The placenta must be handled carefully and gently.


In the case of a placenta that has not been delivered within 30 minutes after delivery, forced manual removal should be avoided. Otherwise, there may be hemorrhage and an infection may develop.


How to diagnose a uterine inversion.


A doctor can usually diagnose a uterine inversion easily. Possible symptoms include:



  • the uterus protrudes from the vagina

  • The uterus does not feel like it's in the right place

  • massive blood loss or rapid decrease in blood pressure


The mother may also experience some of the following symptoms of shock:



  • daze

  • dizziness

  • coldness

  • fatigue

  • short of breath


Investment degrees


Uterine investment is defined by the severity of the investment. These categories include:



  • Incomplete inversion, in which the upper part of the uterus has collapsed, but none of them has crossed the cervix.

  • Complete inversion, in which the uterus is upside down and leaves the cervix.

  • prolapsed inversion, in which the upper part of the uterus leaves the vagina

  • Total investment, in which both the uterus and the vagina are upside down.


How is a uterine investment treated?


Treatment should begin as soon as the uterine inversion is recognized. The doctor may be able to push the upper part of the uterus into the pelvis through the enlarged cervix. If the placenta has not separated, the uterus is usually repositioned.


General anesthesia may be required, such as halothane (Fluothane) gas, or medications such as magnesium sulfate, nitroglycerin, or terbutaline.


Once the uterus is repositioned, oxytocin (Pitocin) and methylergonovine (Methergine) are administered to help the uterus contract and prevent it from reversing again. A doctor or nurse will massage the uterus until it contracts completely and the bleeding stops.


The mother will receive intravenous fluids and a blood transfusion if necessary. You will also be given antibiotics to prevent infections. If the placenta has not yet been delivered, the doctor may have to remove it manually.


There is also a newer technique to correct a uterine inversion using a balloon and water pressure device. A balloon is placed inside the uterine cavity and filled with a saline solution so that the uterus returns to its position.


The procedure is simple and has been successful in placing the uterus. It is also effective in stopping the loss of blood and preventing the uterus from reversing again.


If the doctor can not reposition the uterus manually, an operation may be necessary. The mother will be given anesthesia and her abdomen will be surgically opened. Then the uterus will be repositioned and the abdomen closed.


If a narrow band of tissue contracted in the uterus prevents it from being replaced, an incision can be made along the back of the uterus. Then you can replace the uterus and repair the incision.


If surgery is needed, future pregnancies will require a cesarean delivery. If the placenta can not be separated from the uterus, a hysterectomy may be necessary.


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A uterine inversion is a rare and serious condition. It can cause massive bleeding, shock and can even be fatal. There are factors that put some women at greater risk, but the condition can happen to anyone. In cases where the uterus can not be repositioned, surgery may be required.


The condition is usually easy to diagnose and rapid action and treatment are essential to correct this condition and ensure the health and well-being of the mother. If treated quickly, the mother can recover completely without long-term damage to her uterus.



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Reference: https: //www.healthline.com/health/pregnancy/complications-uterine-inversion






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