Uterine Atony
Understanding Uterine Atony
Uterine atony is a medical condition in which the uterus becomes floppy and unable to contract normally after delivery. It is one of the leading causes of postpartum bleeding, as the lack of uterine contractions prevents the uterus from clamping down and stopping the bleeding.
Women who have recently given birth are at an increased risk for developing uterine atony. This is because the production of hormones such as oxytocin decline after delivery which results in lower uterine muscle contractions. Poorly managed labor, which can include prolonging labor, can also increase the risk of uterine atony.
If left untreated, severe cases of uterine atony may cause excessive bleeding and put the new mother at risk for shock, hypovolemic anemia, or uterine inversion.
Signs and Symptoms
The main symptom of uterine atony is abnormally heavy bleeding after delivery. This can range from mild to severe depending on the severity of the condition. Other signs and symptoms include:
- Foul-smelling discharge
- Uterus remaining soft instead of contracting after delivery of the placenta
- Continued excessive bleeding even after interventions
- Fever or chills
- Weakness or lightheadedness
Treatment
To treat uterine atony, the first line of defense is to use medications such as oxytocin, prostaglandins, and uterotonics. These medications should be used as soon as possible to prevent excessive bleeding and shock. Oxytocin, for example, can help stimulate uterine contractions and stop the bleeding.
If the bleeding is severe enough, a procedure called uterine massage may also be used. Uterine massage involves manual compression of the uterus which can help it contract and stop the bleeding. In some cases, a balloon catheter may be inserted to help the uterus contract from within. This procedure also known as B-Lynch suture should only be done by a qualified surgeon.
Finally, if none of these interventions work, hysterectomy may be performed in severe cases of uterine atony. A hysterectomy is an operation in which the uterus is removed. This should ideally be done with the consent of the patient and only after all other options have been exhausted.