We should know the main uterine atony causes, risk factors, symptoms, and treatment to avoid its complications which may be fatal.
Uterine atony definition
Uterine atony is the weakness of the uterine muscles' contraction in response to oxytocin hormone released by the posterior pituitary gland to the bloodstream during and after childbirth.
This can occur during cesarean or vaginal delivery which leads to postpartum hemorrhage, when these muscles contract squeeze, and shut spiral vessels that have been formed during pregnancy to provide the baby with blood, oxygen, and nutrients from the placenta.
So when the uterine muscles can't contract well during or after delivery, these spiral vessels still bleed, lose significant amounts of blood and endanger the mother's life.
Uterine atony causes
We should know the uterine atony causes and risk factors to avoid them as much as possible because in some cases it is impossible to prevent uterine atony causes so healthcare providers should take all precautions to face postpartum hemorrhage.
The most common uterine atony causes are returned to the insufficient contraction of the uterine muscles in response to the oxytocin hormone which has been released during or after delivery.
These uterine atony causes include
- Very rapid labor
- Prolonged labor
- Induced labor
- Using oxytocin or other drugs or general anesthesia
- Overdistension of the uterus
Risk factors of uterine atony
Many risk factors lead to uterine atony by preventing the contraction of the uterus after childbirth.
These risk factors include:-
- Is this your first baby or do you have more babies (multiple pregnancies)
- You are having twins, triples, or more (over-distended uterus)
- Age more than 35
- Uterine fibroids
- Foetal macrosomia (when the baby is larger than normal)
- Polyhydramnios (have too much amniotic fluid)
- Gestational hypertension or preeclampsia
The risk of uterine atony causes will be high if you have more than one risk factor so healthcare providers should take the necessary precautions before delivery to help them take quick actions.
Uterine atony symptoms
- Excessive and prolonged bleeding from the uterus after childbirth is the main sign of uterine atony.
- Fast heart rate
- Low blood pressure
- Feeling faint and dizzy
- Pale appearance
- Unable to pee
- Loss of consciousness
- Pain, especially in the back
Most cases of uterine atony are detected after delivery while the uterus becomes relaxed, weak, and loose.
Diagnosis of uterine atony
Healthcare providers should detect and diagnose uterine atony early to take action and treat it quickly.
They can diagnose it by feeling the size and softness of the uterus after delivery by placing one hand on the abdomen and at the same time making a vaginal examination with the other hand's fingers.
Some healthcare providers count the sponges or pads used to absorb blood to calculate the amount of blood that has been lost.
In atypical cases, the uterus contract and become hardened and tightened after delivery but in the case of uterine atony, the uterus becomes large, weak, soft, and lose a large amount of blood So healthcare providers should also examine
Tears in the cervix, vagina, and uterus
Retained placental tissue
And they should continue watching for changes in blood pressure and heart rate and they may order blood tests to look at the count of the red blood cells and blood clotting factors.
Treatment of uterine atony
Uterine atony is a serious condition that requires speedy action from the healthcare team, as uterine atony causes severe postpartum hemorrhage, so usually, the goal of the treatment is to stop this postpartum hemorrhage and replace blood or fluids which have been lost by a blood transfusion or iv fluids.
Healthcare providers usually begin the treatment by making massage to the uterus to stimulate more muscular contractions also they may need to give several medications that help the uterus contract,
These medications such as:
Ergot alkaloids (ergometrine)
Healthcare providers also may need to apply pressure on the wall of the uterus to limit the amount of blood loss this has been done by packing the uterus with gauze or inflating the balloon inside it.
Direct pressure on the wall of the uterus may help healthcare providers to stop bleeding.
In some cases, surgical intervention is necessary when all other methods fail to stop bleeding.
These surgical interventions include:
Uterine artery ligation is a procedure that ligate the blood vessels in the uterus.
Uterine curettage is when the healthcare provider scrapes the retained placental tissue or blood from the uterus.
Uterine artery embolization is a procedure that blocks the blood flow to the uterus.
Hysterectomy removes the uterus which is considered the final choice when all methods fail.
Uterine atony complications
Uterine atony causes many complications as:-
- Feeling dizzy
- Postpartum hemorrhage
Anemia and fatigue increase the chance of the mother having postpartum depression.
Also, Uterine atony causes 90% of postpartum hemorrhage which is a life-threatening condition, as with the excessive loss of blood, the blood flow to the body organs like the heart, liver, kidney, and brain decreases and causes postpartum shock.
prevention of uterine atony causes
In many cases, uterine atony causes can't be prevented so if there is any risk of uterine atony causes, healthcare providers should take all precautions to face the bleeding after delivery and stop it.
These precautions include preparing the necessary equipment in the delivery room, having extra help, and may need to change the hospital to another more equipped hospital.
Also during pregnancy, healthcare providers may take some precautions by giving prenatal vitamins and maintaining a healthy weight.
Uterine atony can happen more than once so if you experienced postpartum hemorrhage in a previous delivery you should tell your obstetrician.
Uterine atony causes include the inability of the uterine muscles to contract sufficiently in response to oxytocin hormone during or after childbirth which leads to postpartum haemorrhage and loss of a large amount of blood.
So if you have any risk factor you should tell your healthcare provider to take all precautions and keep you safe after delivery.
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