Uterine atony is a condition when the uterus is unable to contract again after giving birth. This condition can lead to postpartum bleeding that can endanger the life of the mother.
Uterine atony or failure of the uterus to contract is the most common cause of postpartum hemorrhage or bleeding after childbirth which is one of the main factors causing maternal death.
If uterine atony occurs, the bleeding will be difficult to stop. As a result, the mother can lose a lot of blood. It is characterized by increased heart rate, decreased blood pressure, and back pain.
Risks for Experiencing Uterine Atony
The cause of uterine atony is not known with certainty. However, several factors during pregnancy and childbirth are thought to contribute to this condition. These factors include:
- An overstretched uterus due to polyhydramnios
- Twin pregnancy
- Pregnancy with a large baby
- Very fast labor or very long labor
- Induction labor
- Use of drugs such as general anesthetics or oxytocin during labor
A woman is also more at risk of uterine atony if she is pregnant over the age of 35, is obese, has given birth several times, and has a history of obstructed labor.
In addition to fatigue, anemia, and orthostatic hypotension due to bleeding, uterine atony can also cause complications of hypovolemic shock, namely shock due to lack of blood volume that can threaten the mother's life.
Uterine Atony Prevention Steps
Uterine atony sometimes can not be prevented. However, a person's risk for developing this condition can be predicted, although it may be difficult because it is only based on a history and general examination of pregnancy. Unlike abnormalities in the placenta, signs of uterine atony may not be seen before delivery.
Administration of oxytocin after the entire placenta has been delivered and proper uterine massage technique can stimulate uterine contractions and reduce the risk of uterine atony.
In addition, monitoring pulse rate, blood pressure, the amount of blood that comes out closely can detect bleeding early, so that the cause of bleeding can be immediately found.
Pregnant women also need to maintain good health and take pregnancy supplements regularly so that their bodies stay fit until the end of pregnancy and delivery can run smoothly.
Uterine Atony Treatment
Uterine atony will cause bleeding and can be a serious condition that requires emergency treatment. The principle of treating uterine atony is to stimulate the uterus to contract, stop bleeding, and replace lost blood volume. Here are the details:
Installing infusions and blood transfusions
Medical staff will immediately put infusions and blood transfusions. Infusions are placed primarily to provide medication to stop bleeding, while blood transfusions are given to replace lost blood.
Stimulate uterine contractions
The doctor will give you drugs to stimulate uterine contractions, such as oxytocin, prostaglandins, and methylergometrine, to help the uterus to contract more quickly.
Doctors can also stimulate uterine contractions by massaging the uterus. This action is done with one hand inside the uterus and the other hand massaging the uterus from the outside.
Perform uterine blood vessel embolization
If the above steps don't work, the doctor may perform uterine vein embolization, which is to inject a substance to block blood flow to the uterus. Doctors can also perform surgery to tie the uterine blood vessels.
If all efforts have been made, but still cannot overcome the bleeding due to uterine atony, surgical removal of the uterus is required to save the mother's life.
Sometimes uterine atony cannot be prevented, especially if the medical history of current or previous pregnancy is not clearly known. Therefore, every pregnant woman needs to consult regularly and provide a complete medical or pregnancy history to the doctor so that complications during childbirth can be prevented.
Not only that, obstetricians can also suggest hospitals that can support childbirth well, especially for those who are at risk for uterine atony. The reason is that with good supporting facilities, the treatment of uterine atony obtained will also be maximized.