| :: |
Reposition
the uterus immediately. With the passage of time, the
constricting ring around the inverted uterus becomes
more rigid and the uterus more engorged with blood. |
| :: |
If
the woman is in severe pain, give pethidine 1 mg/kg or
morphine 0.1 mg/kg body weight IM or IV slowly. |
| :: |
Give
a single dose of prophylactic antibiotics after correcting
the inverted uterus:
| • |
Ampicillin
2 g IV plus metronidazole 500 mg IV |
| |
Or |
| • |
Cefazolin
1 g IV plus metronidazole 500 mg IV). |
|
| :: |
If
there are signs of infection (fever, foul-smelling vaginal
discharge), give antibiotics, as for metritis. If necrosis
is suspected, perform vaginal hysterectomy. This may require
referral to a tertiary care centre. |
| :: |
Do
not give oxytocic drugs until the inversion is corrected. |
