High urgency
-Moderately severe
At the end of labor, the placenta detaches and the uterine muscles contract to close the vessels that connect the uterus to the placenta. If the muscle tone is not strong enough to close the vessels and prevent bleeding, this is called uterine atony.
It is usually caused by situations that distend the uterus, such as multiparity, or by changes related to the placenta, such as the presence of placental abruption and placenta previa.
It is the most common cause of postpartum hemorrhage. It can be serious and life-threatening to the mother if not treated quickly.
The treatment of choice is a drug called oxytocin, which causes the uterus to contract. In severe cases where bleeding persists, urgent surgery may be required; in very severe cases, this may mean removal of the uterus.
- Michael A Belfort, MBBCH, MD, PhD, FRCSC, FRCOG. Overview of postpartum hemorrhage. UpToDate.
- Sheldon WR, Blum J, Vogel JP, et al. Postpartum haemorrhage management, risks, and maternal outcomes: findings from the World Health Organization Multicountry Survey on Maternal and Newborn Health. BJOG 2014; 121 Suppl 1:5.
- Marshall AL, Durani U, Bartley A, et al. The impact of postpartum hemorrhage on hospital length of stay and inpatient mortality: a National Inpatient Sample-based analysis. Am J Obstet Gynecol 2017; 217:344.e1.
- Wetta LA, Szychowski JM, Seals S, et al. Risk factors for uterine atony/postpartum hemorrhage requiring treatment after vaginal delivery. Am J Obstet Gynecol 2013; 209:51.e1.
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