O71.2

Clinical Causes: Excessive or abrupt pulling on the umbilical cord during delivery In abnormal placental attachment, such as placenta accreta or previa Fundal pressure applied during delivery to assist fetal delivery Uterine atony or weakness, compromising the uterus's ability to stay upright Inexperienced or improper obstetric techniques during labor and delivery

Key Symptoms: Sudden lower abdominal pain Vaginal bleeding that may be heavy A visible or palpable mass protruding from the vagina Signs of shock, such as dizziness, weakness, or rapid heartbeat Decreased uterine tone or feeling the uterine fundus below the usual position during examination

Diagnosis Path: Diagnosis is primarily clinical, based on physical examination. Criteria include observing the uterus turned inside out, often accompanied by bleeding and shock signs. Ultrasound imaging can support diagnosis by visualizing the inverted uterus and assessing associated conditions. Rapid assessment and differentiation from other postpartum complications are crucial. Medical professionals typically examine the patient, noting the absence of the uterine fundus in its normal position and the presence of a mass or protrusion in the vagina.

Treatment Protocols: Immediate management focuses on stabilizing the patient and correcting the inversion. Approaches include: - **Repositioning Techniques:** Manual or surgical methods to reverse the inversion, such as the Johnson maneuver or hydrostatic procedures. - **Hemodynamic Stabilization:** Administering IV fluids and blood transfusions to manage blood loss. - **Medication:** Uterotonics to promote uterine contraction after repositioning. - **Surgical Intervention:** If manual methods fail, surgical procedures like hysterectomy or uterine fixation may be necessary. Post-repositioning care involves monitoring for further bleeding, infection prevention, and addressing any underlying conditions that contributed to the inversion.