In plain words
Uterine atony means the uterus does not contract firmly after the baby and placenta are born. Normally the muscle squeezes shut the vessels where the placenta was attached. When it stays soft, bleeding can be heavy. A boggy, soft uterus that rises above the belly button is a warning sign. Atony causes most cases of heavy bleeding right after birth. It is more likely after a long labor, a , a twin birth, or some medicines used in labor. Care teams check the uterus often in the first hours and use medicines and massage to help it tighten. Bleeding that soaks pads quickly is a reason to call 911 or go in now.
The deeper version
Uterine atony is failure of the to sustain the contraction that compresses spiral arteries after placental delivery. It accounts for roughly 70 to 80 percent of primary (ACOG Practice Bulletin 183, 2017; WHO 2012 recommendations). Risk factors include prolonged labor, , overdistension from multiple gestation or polyhydramnios, macrosomia, grand multiparity, and prolonged exposure. Diagnosis is clinical, by palpation and bleeding volume, with blood loss often underestimated. The first-line response is uterine massage and agents, with escalation to balloon tamponade or surgical measures. Controversy continues over the sensitivity of blood-loss estimation and over whether routine third-stage uterotonic use should be universal.
Where it comes up
- Heavy bleeding after birth (hemorrhage)Birth and the First Days
- Afterpains: cramping while nursingPostpartum: Your Body
- The stages of labor, plainlyBirth and the First Days
- The hospital stay: what happens, what to askBirth and the First Days
What mothers here say about uterine atony
No one has posted under this term yet.
Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 183: Postpartum Hemorrhage, 2017
- World Health Organization — WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage, 2012
- Royal College of Obstetricians and Gynaecologists — Green-top Guideline No. 52: Prevention and Management of Postpartum Haemorrhage, 2016