Re: OB: Inverted uterus

From: Pat Sonnenstuhl (webmidwife1@home.com)
Sat Mar 13 09:47:34 1999


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I am curious why you mention home birth here. Was this in reference to something someone said/asked previously? IMHO a competent and well trained midwife would statistically not have an inverted uterus, as she/he would know when to stop ! My concerns are with thei FP who didn't seem to know what he was doing. I have seen one uterine inversion by a very aggressive physician. Pulled and tugged on the cord. Sometimes there will be a cervical prolapse, which eventually resolves. I believe this is a rare event, and in general most of the time has to do with mismanagement of the third stage. I have heard of it happening occasionally, spontaneously, but it would seem there would need to be some force that would prompt it. I am looking forward to a discussion of this issue.

>
> I will spare you the comments I heard about home deliveries
>
> Questions:
> 1) How often have people seen this in primips - I have only had 2 in
> practice so far and they have both been in primips.
>
> 2) All present at the delivery deny there was significant traction on
> the cord. How often have you seen this without identifiable risk
> factors at delivery?
>
> 3) What would you qoute for recurrence risk?
>
> 4) Appart from awareness, vigilance, and basically hands off the
> placenta and cord - what else would you recommend in any future
> pregnancy/delivery?
>
> 5) Any other comments?
>
> John
>
> --
> J.G.M.Robertson MD, 109-9181 Main St. Chilliwack, B.C. V2P 4M9, Canada
> (604) 793-9988 e-mail john.robertson@obgyn.net
> Who is wise and understanding among you? Let him show it by his good life,
> by deeds done in the humility that comes from wisdom. James 3 vs 13, NIV





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