Content
Uterine atony corresponds to the loss of the ability of the uterus to contract after delivery, 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 in order to prevent complications during or after childbirth, with the administration of oxytocin in the third phase of labor to promote uterine contraction being normally indicated. and thus avoid atony.
Why it happens
Under normal conditions, after the placenta leaves, the uterus contracts with the aim of promoting hemostasis and preventing excessive bleeding. However, when the ability of the uterus to contract is impaired, the uterine vessels responsible for promoting hemostasis do not work properly, favoring the occurrence of bleeding.
Thus, some of the situations that can interfere with the ability of the uterus to contract are:
- Twin pregnancy;
- Obesity;
- Uterine changes, such as the presence of fibroids and bicornuate uterus;
- Treatment of pre-eclampsia or eclampsia with magnesium sulfate;
- Prolonged delivery;
- Age of women, being more frequent in women under 20 years old and over 40 years old.
In addition, women who have had uterine atony in previous pregnancies are at increased risk of having another pregnancy in the future and, therefore, it is important that it is communicated to the doctor so that prophylactic measures can be taken to prevent 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, there may be loss of large amounts of blood, which can put a woman's life at risk. Learn more about postpartum hemorrhage.
In addition to hemorrhage, uterine atony can also be associated with other risks and complications such as kidney and liver failure, changes in the clotting process in the body, loss of fertility and hypovolemic shock, which is characterized by great loss of fluids and blood and progressive loss of heart function, which results in a decrease in the amount of oxygen distributed by the body and can put a person’s life at risk. Understand what hypovolemic shock is and how to identify it.
How is the treatment
To prevent uterine atony, it is recommended that oxytocin be administered when the woman enters the third stage of childbirth, which corresponds to the expulsion period. That's because oxytocin is able to favor the contraction of the uterus, facilitating the baby's expulsion 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 can be performed in order to reduce or stop bleeding, and it 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, and it is then possible to resolve the bleeding. See how the hysterectomy is performed.
Created by: Tua Saúde Editorial Team
Bibliography>
- Portal of Good Practices in Women, Children and Adolescents' Health. Postpartum hemorrhage. 2018. Available at:.
- PERIARD, Alexandre M .; REZENDE, Bruno M .; SECOND, Elzo V .; COSSO, Flávio M. G. et al. Uterine atony and postpartum hemorrhage. Rev Med Minas Gerais. 4th ed. Vol 21; 2011