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 ?
In our study, preloading with 20ml/kg Ringer's Lactate solution, left uterine displacement, supplementation of oxygen via face mask and vasopressor agent inj.
All three groups earned similar scores on questions relating to left uterine displacement during resuscitation and the 5minute cesarean rule.
But, in 1976, Clark et al (8), after observing hypotension as persistent problem, studied the combined effect of left uterine displacement and volume preloading on the incidence of hypotension and reported that fluid preloading alone or combination of fluid preloading and left uterine displacement is an effective means of controlling hypotension in parturients.
Similarly, Mathru et al (11) in 1980, in their study showed that infusion of 5% albumin in D5RL in combination with left uterine displacement is an effective method of acute hydration for prevention of hypotension during Caesarean section performed under spinal anesthesia.
In 1959, Kennedy and coworker (5), found that relieving inferior vena caval occlusion by left uterine displacement could correct maternal hypotension prior to vaginal delivery under spinal anaesthesia.
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).
Case series revealing that moving a woman from supine to a 45[degrees] left tilt or lateral position was an effective means of relieving the symptoms of aortocaval compression preceded the introduction of many different methods of uterine displacement.
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).