inversio uteri

INVERSIO  uteri
 

A  healthy pregnant women can lose blood as much as 10% of the total volume without clinical symptoms. New symptoms appear in 20% blood loss. If bleeding continues, there may be shock. Easy diagnosis of postpartum haemorrhage when at each birth after birth are routinely measured blood loss in the third stage and one hour afterward. In case of postpartum haemorrhage and placenta unborn, necessary to arrange for delivery of the placenta immediately

Postpartum haemorrhage is the loss of more than 500 ml of blood through the birth canal that occurs during or after the third stage. Estimated blood loss is usually not as much as the real, sometimes only half of the truth. The blood mixed with amniotic fluid or urine. Blood was also dispersed on sponges, towels and linen, in buckets and on the floor. The volume of blood lost may also vary as a result according to the maternal hemoglobin levels. Someone mothers with normal hemoglobin levels will be able to adjust to the loss of blood that would be fatal to the anemia.
Postpartum hemorrhage is an important cause of maternal mortality; ¼ maternal deaths are caused by bleeding (postpartum bleeding, placenta previa, placenta solutio, ectopic pregnancy, abortion, and uterine rupture) due to postpartum haemorrhage. In addition, in circumstances where postpartum hemorrhage not cause death, incidence of postpartum morbidity is greatly affected because of anemia can lower the body's resistance.

Clinical classification

Postpartum haemorrhage is divided into primary and secondary postpartum hemorrhage:

1. The primary postpartum haemorrhage (Early Postpartum Haemorrhage, or immediately postpartum hemorrhage).
The primary postpartum hemorrhage occurred in the first 24 hours. The main causes of primary postpartum hemorrhage is uterine atony, retained placenta, retained placenta, and rips the birth canal. Most within the first 2 hours.
2. The secondary postpartum hemorrhage (Late Postpartum Haemorrhage, or bleeding during childbirth, or postpartum bleeding is slow, or PPP kasep) .Perdarahan secondary postpartum occur after the first 24 hours. The main causes of postpartum hemorrhage secondary is tearing of the birth canal and the rest of the placenta or membranes.
Postpartum hemorrhage one of which can be caused by:
Inversio uteri is the top of the uterus enters the cavity of the uterus, thus fundus inner protruding into the uterine cavity. At inversio uteri, uterine fundus distorted so as contained in the mucus membranes of the vagina with the outside of this state is called uterine inversio complete. If only fundus bend inward and not outward cervix, uterine inversio called incomplete. If the uterus which rotates behind it out of the vulva, called inversio prolapse.
At inversio chronic uteri, which were found some time after delivery, preferably in wait for the end of involution later in doing vaginal surgery. Inversio uteri are rare, but if it happens, it can cause severe shock.

Inversio uteri ways:
• Abdominal: Haultain and Huntington
• Vaginal: kustner (posterior fornix) and Spinelli (anterior fornix).