The uterus is one of the fundamental organs during reproduction. It is the organ where a fetus grows and develops. The uterus in its usual size measures approximately 7 cm if there are no fibroids or other medical conditions. But did you know that the uterus during pregnancy increases its size by up to 1000 times more? Therefore, right after childbirth the uterus begins the process to shrink to its normal size. In this article we are going to talk about Atony of the Uterus, what is it, causes, risk factors, prevention, management and treatment. Ready? Let’s begin.
Everything you need to Know About Atony of the Uterus.
First let’s take a look at why it is important that the uterus shrink appropriately after childbirth.
The importance of the uterus shrinking after childbirth goes beyond an aesthetic issue. The first cause of hemorrhage after giving birth is due to a failure of the uterus to contract, this condition is known as atony of the uterus and if it is not detected and treated in time it can be fatal for the mother.
What is Atony of the Uterus.
Atony of the uterus is a dangerous disorder that can happen following childbirth. It occurs when the uterus fails to contract following birth and can result in a potentially fatal disease called postpartum hemorrhage.
Postpartum hemorrhage is considered to be the loss of more than 500 mL of blood after delivery, it occurs in up to 18 percent of births and is the most common maternal morbidity in developed countries. Although risk factors and preventive strategies are clearly documented, not all cases are expected or avoidable. Even with appropriate management, approximately 3 percent of vaginal deliveries will result in severe post-partum hemorrhage.
Following delivery of the baby, the uterine muscles generally contract in order to deliver the placenta. Additionally, the contractions assist in compressing the blood veins linked to the placenta. Compression aids in preventing bleeding. If the uterine muscles are not sufficiently contracted, the blood vessels can flow freely. As a result, excessive bleeding, or hemorrhage occurs.
If you have uterine atony, you will require prompt medical attention to help stop the bleeding and replenish the lost blood. Postpartum hemorrhage is a potentially fatal condition. Early discovery and treatment, on the other hand, can result in complete recovery.
Atony of the Uterus signs and symptoms.
The good news is that Atony of the uterus is usually easily diagnosed right after childbirth, to be exact is usually diagnosed within the 24 hours following childbirth, meaning you are still at the hospital. Atony of the uterus is when the uterus stays relaxed and not tense after giving birth. When the uterus isn’t contracting properly, it can cause blood to leak out of the body after giving birth.
The signs of hemorrhage after childbirth are:
- Following the birth of the baby, there was a lot of bleeding that was not controlled.
- Low blood pressure.
- Increased heart rate.
- Abdominal or pelvic pain.
- Backpain.
Atony of the Uterus: Possible Causes.
The muscles of the uterus may be unable to contract after labor due to a variety of causes. These are some of them:
- Long or prolonged labor time, mainly the last phase of labor.
- Very quick labor.
- Overdistention of the uterus, or excessive enlargement of the uterus due to multiple pregnancy such as Twins or triplets. Excessive amount of amniotic fluid etc.
- The use of oxytocin (Pitocin) or other medications, as well as general anesthesia, are used during delivery.
- Labor that has been induced.
Risk Factors for uterine atony:
- Fetal macrosomia is a condition in which your baby is significantly larger than average.
- You’ve reached the age of 35.
- You’re overweight.
- You are pregnant with multiple babies (twins or Triplets), or have polyhydramnios, a condition in which you have excessive amount of amniotic fluid.
- You’ve given birth many times before.
- History of postpartum hemorrhage.
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Diagnosing Uterine Atony
Atony of the uterus is typically detected right after childbirth, when the uterus is floppy and relaxed after delivery and there is heavy bleeding. Your doctor can determine the amount of blood lost by counting soaked pads or weighing the sponges used to absorb blood.
Additionally, your doctor will do a physical examination and rule out any other possible causes of bleeding. This includes checking for rips in the cervix or vagina and for remnants of the placenta remaining in the uterus.
Additionally, your doctor may test or monitor the following:
- Pulsation rate.
- Arterial blood pressure.
- Count of red blood cells.
- Blood clotting factors.
According to Blood Transfusion in Clinical Practice, uterine atony accounts for up to 90% of postpartum hemorrhage instances. Hemorrhage typically occurs following the delivery of the placenta.
Additional complications of uterine atony include the following:
- Orthostatic hypotension, which is lightheadedness or dizziness due to low blood pressure.
- Anemia.
- Fatigue.
- An increased risk of postpartum hemorrhage in a later pregnancy.
- Anemia and fatigue after birth also increase the chances of a mother having postpartum depression.
- A serious complication of atony of the uterus is hemorrhagic shock. This condition can even be life-threatening.
Atony of the Uterus Treatment.
The goal of treatment is to halt the bleeding and replace the blood that has been lost. As quickly as possible, the mother may be given IV fluids and/or blood.
- Uterine massage, in which your doctor inserts one hand into the vagina and pushes against the uterus while compressing the uterus through the abdominal wall with the other.
- Uterotonic agents, such as oxytocin, ergot alkaloids, and prostaglandins.
- Transfusions of blood if necessary.
In severe circumstances, treatment may involve the following:
- Surgical procedure to sever the blood vessels.
- Embolization of the uterine artery, which entails injecting tiny particles into the uterine artery to prevent blood flow to the uterus.
- Hysterectomy in the event that all other therapies are ineffective.
Preventing Uterine Atony.
Uterine atony cannot always be avoided or prevented. It is critical that your doctor understands how to handle this issue after labor. If you have a high risk of uterine atony, you should deliver your baby at a hospital or birthing center equipped to deal with blood loss. An intravenous (IV) line should be prepared, as well as medication. At all times, nursing and anesthetic professionals should be available. Additionally, notifying the blood bank of the probable need for blood may be necessary.
To diagnose hemorrhage, your doctor should examine your vital signs and the amount of bleeding that happens following birth. Oxytocin administered immediately after delivery can assist the uterus in contracting. Uterine massage immediately following placental delivery may also help lessen the likelihood of uterine atony and is currently a widespread practice.
Prenatal vitamins, particularly those containing iron, can also help avoid anemia and other issues associated with uterine atony and hemorrhage following delivery.
Other posts you might like to check after.
How to Relieve Stress During Pregnancy.
Postpartum depression. Causes, symptoms and prevention.
Leg Cramps During Pregnancy: What to Do.
Final thoughts about Atony of the Uterus.
Postpartum hemorrhage is a leading cause of death following childbirth in countries with poor healthcare infrastructure and a shortage of qualified healthcare staff. In the United States, postpartum hemorrhage is far less common. It occurs in less than 1% of instances.
I hope you find this article helpful, feel free to share your thoughts below.
Zadi, xo
Disclaimer: The medical information on this post is for educational and entertainment use only. Under no circumstances, this information is to replace your doctor’s advice or to treat any disease. For proper care, always visit your doctor.
