When massaging a boggy uterus to expel clots, which action helps prevent uterine inversion?

When massaging a boggy uterus to expel clots, which action helps prevent uterine inversion?

• A. Have the client void before assessment
• B. Simultaneously apply pressure over the lower uterine segment
• C. Stop fundal massage
• D. Have the client bear down

Answer: (B)

When a uterus is boggy, fundal massage is used to stimulate contraction and expel clots, but you also need to keep the uterus from turning inside out. Applying steady pressure on the lower uterine segment provides countertraction as you massage the fundus. This anchoring stabilizes the uterus and prevents the fundus from slipping downward and inverting while you work to express clots. Stopping massage would leave the uterus boggy and bleeding risk remains; bearing down increases abdominal pressure and can promote inversion; voiding beforehand doesn’t address this risk. So, the coordinated action of fundal massage with counterpressure on the lower uterine segment best prevents inversion.

When a uterus is boggy, fundal massage is used to stimulate contraction and expel clots, but you also need to keep the uterus from turning inside out. Applying steady pressure on the lower uterine segment provides countertraction as you massage the fundus. This anchoring stabilizes the uterus and prevents the fundus from slipping downward and inverting while you work to express clots. Stopping massage would leave the uterus boggy and bleeding risk remains; bearing down increases abdominal pressure and can promote inversion; voiding beforehand doesn’t address this risk. So, the coordinated action of fundal massage with counterpressure on the lower uterine segment best prevents inversion.