Uterine Displacement


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Uterine Displacement

 

a deviation from the normal position of the uterus in the lesser pelvis.

The displacement of the uterus may be forward, backward, or lateral (right or left). With uterine anteflexion, the angle between the body and cervix of the uterus is acute (ordinarily, it is no less than 90°) and open to the front. Such displacement may be congenital or the result of inflammation or inadequate ovarian function. Women suffering from uterine displacement frequently complain of painful menstruation and are often sterile. If pregnancy occurs, the fetus may be aborted because of poorly developed uterine musculature. With flexion to the side, the angle between the cervix and body of the uterus opens to the right or left; with retroflexion, the angle between the body and cervix opens to the rear. Sideward and backward flexion often result from the formation of adhesions (after inflammation in the abdominal cavity) that displace the uterus. Because of inflammation in the abdominal cavity, uterine ligaments, and tissue of the lesser pelvis, the body of the uterus shifts to one side and the cervix to the other. The obtuse angle between the body and cervix may flatten. In old women, retroflexion may occur after the uterus atrophies and its tone decreases. Supportive therapy, hormones, physical therapy, and sometimes surgery are recommended for treatment, depending on the cause of the displacement.

G. E. GOFMAN

References in periodicals archive ?
Suggested measures for preventing hypotension during caesarean delivery include: colloid preload (14), low-dose spinal anaesthesia (14), use of prophylactic vasopressors (3,15), performing a CSEA technique in the left lateral position (9,16), the right lateral position (16,17), the Oxford position (18) or the sitting position (16-18) and using left uterine displacement (7-11).
The traditional method of left uterine displacement places a wedge under the right pelvis with a 12 to 15[degrees] left lateral tilt (5-9), which could change the maternal position and shift the uterus to the left indirectly (5-9).
Effects of position and uterine displacement on spinal anesthesia for cesarean section.
Some caval compression still occurs at 15[degrees] and aortic compression at up to 35[degrees] tilt (as evidenced by reversible reduction in lower limb arterial pressure (l8,19) and improved cardiac output after either manual uterine displacement of women already tilted (20) or after repositioning into the full lateral position (21).
Thus increasing the degree of uterine displacement (e.g.
Imaging and cardiovascular studies, to look for differences in uterine displacement, vascular compression and circulatory responses, associated with different degrees of table tilt and with wedges of various angle and size placed at different anatomical locations during labour epidural analgesia or anaesthesia for caesarean section might be instructive.
Table tilt and/ or a wedge under the lumbar area should be used to achieve obvious uterine displacement in all women in mid to late pregnancy, especially those having epidural analgesia or operative anaesthesia.
In the presence of approximately 25[degrees] pelvic tilt, external cardiac massage can be performed with 80% of the force that could be applied with the patient supine (34) and manual uterine displacement by a dedicated assistant as the woman lies supine is arguably the most pragmatic approach in this setting.