Inversion of the uterus is not caused by:
Ans: a (Controlled cord traction) Ref: Dutta, 6th ed, p. 421Controlled cord traction:Also called modified Brandt-Andrews method. In this, body of the uterus is pushed upwards and backwards with left hand towards the umbilicus. By the right hand steady traction is given in downward and backward direction holding the clamp until the placenta comes outside the introitus.Done by expert hands, chance of inversion of uterus is very less.Inversion of uterus:1st degree-Dimpling of the fundus which still remains above the level of internal OS.2nd degree - The fundus passes through the cervix but lies inside the vagina.3rd degree - Fundus lies outside the vulva.Etiology:Induced - pulling of cord or Crede expressionSpontaneous (40%) - Fundal attachment of placentaComplication:a) Neurogenic shock Late complication - Infectionb) Haemorrhage - Uterine sloughingc) Pulmonary embolism - Chronic inversionHydrostatic method of replacement of uterus - O' Sullivan's method
Controlled cord traction
Undue fundal pressure
Fundal attachment of placenta
Faulty placental extraction
Miscellaneous (Gynae)