Uterine atony: Difference between revisions
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==Overview== | ==Overview== | ||
'''Uterine atony''' is a loss of tone in the [[uterus|uterine]] musculature. Normally, contraction of the uterine [[arteries]] compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. Thus, lack of uterine [[muscle]] contraction can cause an acute [[hemorrhage]]. Clinically, 75-80% of [[postpartum]] hemorrhages are due to uterine atony. | '''Uterine atony''' is a loss of tone in the [[uterus|uterine]] musculature. Normally, contraction of the uterine [[arteries]] compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. Thus, lack of uterine [[muscle]] contraction can cause an acute [[hemorrhage]]. Clinically, 75-80% of [[postpartum]] hemorrhages are due to uterine atony. | ||
==Historical Perspective== | |||
*In 1953, du Vigneaud et al. and Tuppy were the first to discover the [[aminoacid]] sequence of [[oxytocin]] and its biochemical synthesis.<ref name="pmid24259988">{{cite journal |vauthors=Prata N, Bell S, Weidert K |title=Prevention of postpartum hemorrhage in low-resource settings: current perspectives |journal=Int J Womens Health |volume=5 |issue= |pages=737–52 |date=2013 |pmid=24259988 |pmc=3833941 |doi=10.2147/IJWH.S51661 |url=}}</ref> | |||
*In 1962, the use of [[prophylactic]] [[oxytocin|uterotonic agent]], early [[umbilical cord|cord]] clamping, and controlled cord traction were defined by Spencer for the active management of the third stage of [[childbirth|labor]] (AMTSL).<ref name="pmid25631379">{{cite journal |vauthors=Hofmeyr GJ, Mshweshwe NT, Gülmezoglu AM |title=Controlled cord traction for the third stage of labor |journal=Cochrane Database Syst Rev |volume=1 |issue= |pages=CD008020 |date=January 2015 |pmid=25631379 |pmc=6464177 |doi=10.1002/14651858.CD008020.pub2 |url=}}</ref> | |||
==Classification== | |||
There is no established system for the classification of uterine atony. | |||
==Pathophysiology== | |||
==Etiology== | ==Etiology== | ||
Revision as of 15:48, 20 May 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Adnan Ezici, M.D[2]
Overview
Uterine atony is a loss of tone in the uterine musculature. Normally, contraction of the uterine arteries compresses the vessels and reduces flow. This increases the likelihood of coagulation and prevents bleeds. Thus, lack of uterine muscle contraction can cause an acute hemorrhage. Clinically, 75-80% of postpartum hemorrhages are due to uterine atony.
Historical Perspective
- In 1953, du Vigneaud et al. and Tuppy were the first to discover the aminoacid sequence of oxytocin and its biochemical synthesis.[1]
- In 1962, the use of prophylactic uterotonic agent, early cord clamping, and controlled cord traction were defined by Spencer for the active management of the third stage of labor (AMTSL).[2]
Classification
There is no established system for the classification of uterine atony.
Pathophysiology
Etiology
Many factors can contribute to the loss of uterine muscle tone, including:
- overdistention of the uterus
- multiple gestations
- polyhydramnios
- fetal macrosomia
- prolonged labor
- oxytocin augmentation of labor
- grand multiparity (having given birth 5 or more times)
- precipitous labor (labor lasting less than 3 hours)
- magnesium sulfate treatment of preeclampsia
- chorioamnionitis
- halogenated anesthetics
- uterine leiomyomata
References
- Hacker, Neville, J. G. Moore, and Joseph Gambone. Essentials of Obstetrics and Gynecology. 4th ed. Vol. 1. Philadelphia: Elsevier Inc., 2004. 151.
- ↑ Prata N, Bell S, Weidert K (2013). "Prevention of postpartum hemorrhage in low-resource settings: current perspectives". Int J Womens Health. 5: 737–52. doi:10.2147/IJWH.S51661. PMC 3833941. PMID 24259988.
- ↑ Hofmeyr GJ, Mshweshwe NT, Gülmezoglu AM (January 2015). "Controlled cord traction for the third stage of labor". Cochrane Database Syst Rev. 1: CD008020. doi:10.1002/14651858.CD008020.pub2. PMC 6464177. PMID 25631379.