To relax the uterus and allow it to be replaced by the OB practitioner, the anesthesia provider may use Nitroglycerin (most common), Terbutaline, and/or GETA Dose of Nitroglycerine is 50-500 ug titrated to effect. The procedure is painful, so analgesia should be in place. This can be accomplished by an existing epidural catheter, GETA, or ketamine. Give fluids/replace volume. Once the uterus is back in place, oxytocic drugs will be given to induce uterine contractions.
Diagnosis: -Vaginal or perineal mass -Massive Hemorrhage -Shock and Hypotension Risk factors: -Inappropriate fundal pressure -Excessive traction (or pulling) on the umbilical cord. This often happens when practitioners use the umbilical cord to force delivery of the placenta.
