Uterine atony

Uterine atony
Atonic uterus (held by surgeon)
SpecialtyObstetrics
SymptomsUncontrolled postpartum bleeding, decreased heart rate, pain, soft non-contracted uterus
Complicationspostpartum hemorrhage, DIC, hypovolemic shock, renal failure, hepatic failure, and death
Usual onsetthird stage of labor
Causestrauma, complicated labor, medications, uterine distention, caesarean section
Risk factorsObesity, uterine distention, placental disorders, multiple gestation, prior PPH, coagulopathies
Diagnostic methodPhysical exam and observed blood loss
Differential diagnosisuterine inversion, obstetric laceration
PreventionRisk stratification and identification, active management of third stage of labor
TreatmentUterine massage, Oxytocin, uterotonics, tamponade or packing, surgical intervention
MedicationOxytocin (Pitocin), Carbetocin, Methergine, Hemabate or Carboprost, Misoprostol, Dinoprostone
Prognosis2-3 times risk of recurrence
Frequency80% of postpartum bleeding

Uterine atony is the failure of the uterus to contract adequately following delivery. Contraction of the uterine muscles during labor compresses the blood vessels and slows flow, which helps prevent hemorrhage and facilitates coagulation. Therefore, a lack of uterine muscle contraction can lead to an acute hemorrhage, as the vasculature is not being sufficiently compressed.[1] Uterine atony is the most common cause of postpartum hemorrhage, which is an emergency and potential cause of fatality. Across the globe, postpartum hemorrhage is among the top five causes of maternal death.[2] Recognition of the warning signs of uterine atony in the setting of extensive postpartum bleeding should initiate interventions aimed at regaining stable uterine contraction.

  1. ^ Gill P, Patel A, Van Hook JW (2020). "Uterine Atony". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 29630290. Retrieved 2020-10-19. Text was copied from this source, which is available under a Creative Commons Attribution 4.0 International License.
  2. ^ Cite error: The named reference :2 was invoked but never defined (see the help page).