ABSTRACT
There are no randomized trials to determine the optimal management for uterine inversion. Suggested management may include the following:
l Obtain assistance from other obstetricians or experienced providers, nursing staff and anesthesia
l Provide large IV bore access l IV fluid therapy l Withhold uterotonic agents l Avoid separating the placenta to decrease bleeding l Consider uterine relaxing agents
l Magnesium sulfate IV bolus l Terbutaline IV 0.25 SQ l Nitroglycerin 50 to 500 mg orally or anesthesia
l Manual manipulation of the uterus l Reposition the portion of the uterus that inverted last l Grab the uterus with palm and fingers posteriorly and
thumbs anteriorly l Do not use a fist
l Surgical intervention-laparotomy (rarely needed) l Huntington procedure-clamps are placed on the
round ligaments 2 cm deep in the inversion and gentle upward traction applied. Repeat clamping as necessary.
