Treatment and management of uterine atony
There are several treatments that have proven effective in treating postpartum bleeding from uterine atony. Preparing for possible blood loss is needed. Women who are at high risk should have her blood properly typed and cross-matched during labor.
Experts advise active management of the third stage of labor. This includes uterine massage with concomitant sustained low-level traction on the umbilical cord. Simultaneous oxytocin infusion is helpful, although it is okay to defer it to after delivery of the placenta.
Massaging the uterus has proven effective along with ensuring a completely delivered placenta. Medications for postpartum hemorrhage secondary to uterine atony include oxytocin, methylergonovine, 15-methyl-PGF2-alpha, misoprostol, and dinoprostone.
Surgical Treatments available
Should medication fail with continued excess bleeding, doctors may recommend surgery. Obstetricians may use conservative ways to effect uterine contraction including bimanual compression of the uterus and placing multiple compressive sutures.
In 1997, Christopher B-Lynch devised an innovative technique to treat uterine atony. Doctors have used this method successfully around the world. Called the “B-Lynch suture,” it can be applied easily and rapidly.
The B-Lynch suture is a continuous suture to envelope and mechanically compress the uterus. This is an attempt to avoid a hysterectomy.
Two tamponade techniques have been cited for effectiveness. One involves uterine packing with gauze while another involves inserting a Bakri balloon.
Other surgical management techniques are available. Namely, uterine curettage for retained products, uterine artery ligation, hypogastric artery ligation, and finally, if all else fails, a hysterectomy.
As beautiful as the process of childbirth is, there are unexpected things that may happen. Uterine atony is one of these scenarios. This occurs when the uterus fails to contract upon completion of delivery.
Certain women are more likely to have uterine atony related to postpartum hemorrhage. Medications are continuously being developed and discovered for treating these kinds of conditions. A few surgical techniques have proved to be successful when these medications are not enough.
For more on pregnancy complications, click here.
Share your thoughts
Be the first to let Hello Doctor know your thoughts!
Join Us or Log In to join the discussion