Uterine Inversion !!!!

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Just had the evening from you-know-where. A nice delivery turned into hell with the delivery of the placenta and a uterine inversion. Mom went downhill pretty quickly. We are a rural hospital where OR and anesthesia have to be called in. She was taken to the OR in about 45 minutes where she had an emergency hysterectomy to save her life. Last I heard she was getting her sixth unit of blood. At one time her BP was 30 over zip. What a nightmare. At least she is going to live .......I guess there were a few minutes in OR when they weren't too sure she would make it. Anyone who thinks we sit around and rock babies ought to be an L + D nurse for awhile. I do not thrive on emergencies, in fact I hate them but they are always lurking even with a nice delivery........this one went sour pretty quickly. I don't know how long I can do this. My co-workers were a per diem nursery nurse who is basically clueless and a new graduate !!!!!!!! No tech, no secretary, no runner, no aide. Thanks for letting me have a place to vent where others understand. Anyone else here have experience with uterine inversion ???

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Specializes in Med-Surg/Peds/O.R./Legal/cardiology.

mag,

OMG!!! what a nightmare!!! Things sure can turn on a dime! Being able to handle these sorts of situations is what separates the women from the girls!! Hope you're getting some rest. Thank God she's going to make it!! I know you must be exhausted!

ebear

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I totally understand ur situation, i also work in a rual hospital and that has been my grip forever at night no help and doctors at home cozy in their beds and don't wanna be bothered by a phone call. u shud pat urself on the back for a job well done!!!!!!!!!!!!!!!!!

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Specializes in L&D, High Risk OB, OR, Med-Surg, PHN.

]:uhoh21: I have never been involved in this, but I know of 2 inversion's and they happen c 2 GP's thank God that I worked at a facility that had OB there and they took over. We kept Nitroglycerin NS in the PYXIS for treatment of a inverted uterus have you facility investigate the use of this medication it has worked wonders.

:lol2: Lisa

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Specializes in ICU, SDU, OR, RR, Ortho, Hospice RN.

Magz I have witnessed this only once when I did my L&D rotation. Scared the crap outta me!

Bless your heart I wish for you better times ahead. *hugs*

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Specializes in OB.

What a scary night! I've been through some of these types of situations in rural facilities and it can be a horror!

Now that it's over and she's going to make it you can sit down and have the case of the "omigawds" that you deserve - and know that this is one shift where you being there made a real, life saving difference to a patient. Way to go!

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Just curious if cord traction played a factor in this? I have heard it is very rare except in that case. Glad to hear mom is okay.

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Specializes in nursery, L and D.
Just curious if cord traction played a factor in this? I have heard it is very rare except in that case. Glad to hear mom is okay.

Yeah, I always wonder what the proponents of "active management" have to say about this.

I just changed from a rural hospital, to a bigger hospital, so that is a relief for me. To know there is a ton of help near if something like this happens. I'm so sorry you had to deal with all that, and I hope the woman does well.

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Specializes in Community, OB, Nursery.

I was wondering about cord traction too.

I think that bit about the placenta needing to be out in 3-5 min (which is what some of our docs want!! :madface:) is bull.

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Thanks everyone for your support........only an L + D nurse could know how horrible it was. Yes there was cord traction.....and I will testify to that if it comes down to it. As an update though, the pt. is out of ICU, back on our floor and doing well. I heard her tell someone tonight that she only has half a uterus. She thinks because they left her cervix, she has half a uterus. I am not sure she realizes her childbearing days are over........but at least her life is not over. In reading about uterine inversion, makes me realize how close we came to losing her. It happened so fast. Main concerns I heard today was that it took OR staff so long to come in. Of course, I am raking myself over the coals wondering what I could have done better. I felt like a one-man circus making calls, putting things in the computer, getting meds out of the pyxis and then after trying to document accurately.

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She thinks because they left her cervix, she has half a uterus. I am not sure she realizes her childbearing days are over........but at least her life is not over.quote]

That's so sad.. especially if it didn't have to happen. I hope that mom is able to heal quickly and well.

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Specializes in Staff nurse.

When I was a medic in the Army working in OB I was training a new medic during and after a delivery. I showed her how to massage a fundus, watched her and I went to the next pt. 20 minutes later she called for me, and showed me a purple "mass/glob" on the pad, that "came out when i massaged the fundus". I used the "panic button" to alert the nurse who was on the PP side giving PRN meds. Nurse called doc, who was in surgery (small military hosp. on night shift), but we got her ready for surgery. Talk about scary!! She had surgery and then was transferred to a larger hosp. Can't remember if she had hysterectomy...

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