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Uterine Atony (Postpartum)

Failure of uterine contraction after delivery; the most common cause of postpartum hemorrhage.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Uterine Atony (Postpartum)?

Uterine atony develops when the uterus fails to contract adequately after delivery and the vessels of the placental site cannot be closed. It accounts for 70-80% of postpartum hemorrhages and is one of the leading causes of maternal mortality worldwide.

Risk factors include prolonged labor, high parity, macrosomic baby, multiple pregnancy, polyhydramnios, chorioamnionitis, and induction/augmentation. After delivery of the placenta, uterine tone is assessed; a soft and large uterus suggests atony.

Management is stepwise: uterine massage, oxytocin, methylergometrine, carboprost, and misoprostol are given sequentially. If unresponsive, intrauterine balloon tamponade, B-Lynch suture, uterine artery ligation, and finally hysterectomy are performed.

Symptoms

Excessive vaginal bleeding after delivery
Soft and boggy uterus on palpation
Tachycardia and hypotension
Pale skin and cold sweating
Agitation and altered consciousness
Falling hematocrit and hemoglobin
Signs of shock

Risk Factors

Prolonged labor
Multiparity
Macrosomia (birth weight >4000 g)
Multiple pregnancy and polyhydramnios
Chorioamnionitis
Labor induction or magnesium sulfate use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Emergency intervention for massive postpartum bleeding
  • When uterine tone is assessed and found atonic
  • Worsening vital signs
  • Excessive bleeding or clot passage after discharge
  • Weakness, palpitations, and dizziness after discharge

Treatment Methods

01
Uterine massage and bimanual compression
02
Oxytocin infusion (first-line)
03
Methylergometrine, carboprost, misoprostol (second-line)
04
Intrauterine balloon tamponade (Bakri balloon)
05
B-Lynch suture or uterine artery ligation
06
Hysterectomy and massive transfusion as last resort

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.