If the uterus does invert, the main aim of your caregiver is to replace the uterus to its normal position as quickly and as gently as possible, to avoid the woman going into shock and collapsing. The woman may be given a narcotic injection such as Pethidine or Morphine to help with the pain and to relax her or she may be given a light general anaesthetic while the uterus is being replaced.
In some cases if the uterus is proving difficult to replace the woman will be given a medication through the vein to help relax the uterus, usually magnesium sulphate or drugs (such as Ventolin) that are smooth muscle relaxants and usually used to stop premature labour.
If the woman is in shock, she will be given an oxygen mask and fluid via a drip into her vein to help increase her blood pressure and reverse the physical shock.
There are two main methods that can be used to 'replace' the uterus. These include:
Manual replacement. The caregiver will place their fingers inside the vagina, up beside the uterus and gently place pressure on the walls of the uterus that can be felt just outside the cervix (called fornices). This replaces the lower segment of the uterus first and then pressure is put onto the uterine fundus to replace the remainder if the uterus.
Hydrostatic replacement. This method uses warm salt water to replace the uterus. The woman is placed in stirrups and the caregiver places a catheter inside the vagina (like a douche), allowing 2 to 3 litres of warm sterile salt water (the same fluid that is used for drips into the vein) to slowly drain in. The fluid is stopped from flowing out by the caregiver sealing off the vagina, (around their hand that is inside the vagina) with their other hand. The uterus will normally move back into place quite readily.
Either of these procedures would probably be carried out in the delivery suite.