How is uterine inversion treated in postpartum hemorrhage (PPH)?

Updated: Jan 02, 2018
  • Author: Maame Yaa A B Yiadom, MD, MPH; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Answer

Traction

If uterine inversion occurs, gently push the uterus back into position. Do this by pressing the fingers of the dominant hand together to form a tear drop shape. Enter the vagina with the tips of the fingers. Once contact is made with the fundus, use an outward to inward motion of the fingers along with gentle upward pressure to move the uterus through the cervix. If the uterus has contracted down in an inverted position, the patient may be treated with nitroglycerin (50-100 mcg IV) to relax the myometrium and allow uterine replacement. Emergency surgical intervention is indicated if initial replacement attempts fail.


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