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Acute uterine inversion

Shock with a mass in the vagina after birth.

Source: RCOG · local guidelines

Act

  1. Call for help; stop oxytocin.
  2. Leave placenta attached.
  3. Immediate manual replacement (Johnson’s).
  4. Resuscitate in parallel.
  5. Failed: tocolysis, O’Sullivan hydrostatic, or theatre.
  6. After reduction: oxytocin infusion, antibiotics.
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.