oxytocin and Uterine-Prolapse

In Europe, one inversion per 25,000 births is expected with present day obstetric management. Faulty management of the third stage of labour may increase the incidence many-fold. North American figures show that the omission of medications during the third stage of labour and traction on the umbilical cord have increased the incidence to 1 in 2,000. Whether cord traction is as free of danger as has been claimed within recent years, needs to be re-evaluated. The classical symptoms and signs of inversion of the uterus are pain, vascular shock and bleeding. If manual reposition of the uterus occurs immediately following the inversion, even without anesthesia, severe complications and post-operative morbidity are low. Following inversion of the uterus, further normal pregnancies can be expected.

Topics: Adult; Female; Humans; Oxytocin; Pregnancy; Prognosis; Puerperal Disorders; Uterine Prolapse

The normal physiology of the third stage of labour and the effect of oxytocics at the end of the second stage have been discussed. An assessment of the results of different policies of third stage management has been made, including a comparison of the advantages and disadvantages of the traditional method versus the use of controlled cord traction. It is recommended that ergometrine (0.25 mg) be administered intravenously after delivery of the baby, and the exclusion of a second twin. Once the uterus has contracted the placenta should then be delivered by the technique of controlled cord traction.

Topics: Delivery, Obstetric; Ergonovine; Female; Humans; Labor Stage, Third; Oxytocin; Placenta; Postpartum Hemorrhage; Pregnancy; Time Factors; Traction; Uterine Prolapse