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.