Atonic Uterus

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Definition

-  Failure of adequate uterine contraction post labour & delivery

  

Features

-  5% births

-  Most common cause of PPH

-  Focal areas of uterus may atonic

 

Associated S/S

-  Overdistension

-  Multiple gestations (twins..)

-  Polyhydramnios

-  Macrosomia

-  Uterine infection: endometritis (PID)

-  Meds

-  Uterine fatigue: prolonged labour

-  Retained placenta or fragments (placenta accreta..)

 

Complications

-  PPH

 

Mx

-  Rubbing up uterus

-  Uterotonics

-  Oxytocin for active Mx third stage of labour

-  Syntometrine (if normotensive) OR Syntocinon (if HTN)

-  +/- Ergometrine (not if Syntometrine given)

-  Bakri balloon

-  Mx of PPH as necessary

 

 

 

References