Uterine inversion is a life-threatening obstetric emergency that requires immediate treatment to prevent hemorrhagic shock and death. The diagnosis is based on clinical findings of bleeding and palpation of the inverted uterus. The first steps in treatment are to stop oxytocin, establish IVs, and manually replace the inverted uterus. If manual replacement fails, intravenous nitroglycerin can be used to relax the uterus and allow replacement, with doses up to 1000 micrograms. Surgery may be required if inversion persists after attempts at uterine relaxation and manual replacement.

1. Life-Threatening Obstetrical Emergency May 2010