Uterine inversion is a rare complication of the third stage of labor where the fundus of the uterus turns inside out and protrudes through the vaginal opening. It occurs when the uterus is atonic and the placenta is still attached, and can lead to excessive bleeding if not quickly corrected. Diagnosis is apparent if the shaggy ball of the inverted uterus is seen protruding from the vagina, and treatment involves manually repositioning the uterus while controlling blood loss with IV fluids before giving oxytocin to firm the uterus.

1. Uterine Inversion Donna Adelsperger, RN, M.Ed

2. Definition: Uterine Inversion Uterus turned inside out in 3 rd stage labor Occurs when uterus is atonic and cervix open and placenta attached Fundus of uterus moves through the vagina and the tugging on peritoneal structures causes strong vasovagal response leading to hypotension

3. Uterine Inversion If placenta is completely or partially separated bleeding is excessive If not quickly corrected it may become life-threatening Occurs very rarely Occurs when health care provider exerts fundal pressure while tugging on the cord

4. Uterine Inversion: Management Diagnosis is apparent if a shaggy ball is seen with placenta attached and it is protruding from the vaginal opening Signs of hypovolemic shock occur so need for rapid infusion IV fluids (No oxytocin) Get help!!!

5. Uterine Inversion: Management Placenta should be manually removed Gradual, continuous replacement of uterus After uterus replaced oxytocin used to increase uterine firmness to control bleeding at placental site