Management
Principles of management are to treat the shock and replace the uterus. Immediate manual replacement of the uterus has about a 20 - 40% chance of success. Removing the placenta increases blood loss. The cervix may need to be relaxed using tocolysis or general anaesthesia. Tocolytics include terbutaline, MgSO4, and Nitroglycerine (100mcg intravenously). If external replacement fails, a laparotomy may be required, in which the uterus is gently pulled the right way round using forceps.
Read more about this topic: Uterine Inversion
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