Re: Inverted uterus
From: Pat Sonnenstuhl (webmidwife1@home.com)
Mon Mar 15 08:20:12 1999
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My original point precisely. One doing deliveries should be familiar
enough with what an Inverted Uterus is so that they can act in a timely
manner. Thus my concern that the FP mentioned didn't recognize what he
had.
Braun, R. Daniel wrote:
>
> R. Daniel Braun, MD FACOG
> Clinical Professor
> Department of Obstetrics and Gynecology
> Indiana U. School of Medicine
> Indianapolis, IN
>
> 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.
>
> This is usually related to implantation site more than anything
> else. A perfect fundal implantation is all that is required to have it.
>
> 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?
>
> Doesn't need traction on cord. This is one of those old wives tales.
>
> 3) What would you qoute for recurrence risk?
>
> Slim to none.
>
> 4) Appart from awareness, vigilance, and basically hands off the
> placenta and cord - what else would you recommend in any future
> pregnancy/delivery?
>
> See above.
>
> 5) Any other comments?
>
> It happens. All persons doing deliveries should know about inverted
> uterus and how to immediately replace it. The morbidity of inverted uterus
> is directly related to delay in replacement. The difficulty in replacement
> also increases as time goes on. The worst one I ever had was a lady
> transferred in by a GP(in those days it was GP) It was 6 hours since she had
> delivered. We had to put her to sleep and do a laparotomy. The diagram in
> Williams Obstetrics is 100% accurate. It looks like a hole where the fundus
> ought to be with the tubes and rounds disappearing into it. We were able to
> then grab the rounds and pull it up.
> The section on this in Williams Obstetrics is excellent.
>
> 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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