Uterine atony corresponds to the loss of the uterus’ ability to contract after childbirth, which increases the risk of postpartum hemorrhage, putting the woman’s life at risk. This situation can happen more easily in women who are pregnant with twins, who are under 20 years old or over 40 years old, or who are overweight.
It is important that the risk factors for uterine atony are identified so that prophylactic treatment can be established with the aim of preventing complications during or after childbirth, and the administration of oxytocin is normally indicated in the third phase of labor to promote uterine contraction. and thus avoid atony.
Why does it happen
Under normal conditions, after the placenta is delivered, the uterus contracts with the aim of promoting hemostasis and preventing excessive bleeding. However, when the uterus’ ability to contract is impaired, the uterine vessels responsible for promoting hemostasis do not function correctly, favoring the occurrence of bleeding.
Thus, some of the situations that can interfere with the uterus’ ability to contract are:
- Pregnancy of twins;
- Obesity;
- Uterine changes, such as the presence of fibroids and a bicornuate uterus;
- Treatment of pre-eclampsia or eclampsia with magnesium sulfate;
- prolonged labor;
- Age of the woman, being more common in women under 20 and over 40.
Furthermore, women who have had uterine atony in previous pregnancies are at greater risk of having it again in another pregnancy and, therefore, it is important that this is communicated to the doctor so that prophylactic measures can be adopted to avoid atony.
Risks and complications of uterine atony
The main complication related to uterine atony is postpartum hemorrhage, because the uterine vessels are unable to contract properly to promote hemostasis. Thus, a large amount of blood can be lost, which can put the woman’s life at risk. Learn more about postpartum hemorrhage.
In addition to hemorrhage, uterine atony may also be associated with other risks and complications such as kidney and liver failure, changes in the body’s coagulation process, loss of fertility and hypovolemic shock, which is characterized by large loss of fluids and blood and progressive loss heart function, which results in a decrease in the amount of oxygen distributed throughout the body and can put the person’s life at risk. Understand what hypovolemic shock is and how to identify it.
What is the treatment like?
To prevent uterine atony, it is recommended that oxytocin be administered when the woman enters the third stage of labor, which corresponds to the period of expulsion. This is because oxytocin is capable of promoting contraction of the uterus, facilitating the expulsion of the baby and stimulating hemostasis.
In cases where oxytocin does not have the desired effect, it may be necessary to perform a surgical procedure to prevent bleeding and treat uterine atony, and uterine tamponade may be performed with the aim of reducing or stopping bleeding, and is also recommended. the use of antibiotics and oxytocin to guarantee the result.
In more serious situations, the doctor may recommend a total hysterectomy, in which the uterus and cervix are removed, making it possible to resolve the bleeding. See how a hysterectomy is performed.
