Obstetric and Gynecological Nursing - The Carter Center

Forced inversion caused by excessive pulling of the cord or
vigorous manual expression of the placenta or clots from an
atonic uterus
Spontaneous inversion is due to increased abdominal
pressure because of bearing down, coughing, or sudden
abdominal muscle contraction.
Recognition
Sudden onset of shock is the out standing sign accompanied
by sever gain which is caused by the ovaries being dragged in
to the inverted fundus.
Bleeding may or may not be present depending upon the
degree of placental adherence to the uterine wall.
The cause may not always be readily apparent as only in
extreme cases is the fundus visible out side the vagina. Partial
inversion may be present where the fundus does not pass
through the cervix; it may however have extruded into the
vagina.
Up on palpation a concave shape will be feet at the fundus; if
the inversion is complete, none of the uterus will be palpable.
A vaginal examination will reveal the inversion.
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