Auto text: “Insert Uterus Post Partum”

Clinical Info

• Done for uncontrolled bleeding, placenta accreta, subinvolution of the implantation site vessels, and dysplasia.
• Cervix may be difficult to identify; the uterus looks like a large sack.

Triage

1. Weigh specimen and measure:
   • 3 dimensions of uterus (C-C, Fundus-LUS, A-P).
   • 3 dimensions of cervix (face and length).
   • shape, diameter of os.
   • bilateral ovaries (3D) and fallopian tubes (2D), if present.
2. Identify anterior and posterior sides and note quality of serosa. (The peritoneal reflection extends further inferiorly on the posterior side. The tube is anterior to the ovary).
3. Ink outer surface: anterior blue and posterior black.
   • If bladder peritoneum is present, ink this a different color.
4. Coronally bisect uterus through 3:00 and 9:00 positions.
5. Measure endocervical canal and endometrial cavity in 2 dimensions, and thickness of endometrium and myometrium.
6. Measure any lesions (whorled nodules, polyps, etc).
7. Measure placenta and cord if present. Describe location of placental attachment to cavity.

Gross

1. If any placenta is present, take representative umbilical cord (2 sections) and membrane roll as you normally would for a placenta.
2. For placenta previs, look for placental tissue overlying the cervix and submit representative sections.
3. For placenta accreta/increta/percreta, look for tissue adherent to the endometrium. Submit representative sections of the deepest extent of placental invasion into myometrium.
   • If attached bladder peritoneum is present, be sure to sample this in continuity with outer myometrium/serosa.
4. Gross the reminder of the specimen as a benign uterus.

Updated 6-22-2020 SRR