Uterine atony
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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
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
It is thought that the uterine atony is caused by inadequate contraction of the myometrium following the delivery. Physiologically, contraction of the myometrium occurs in response to oxytocin, therefore, mediates the uterine hemostasis by mechanically compressing the blood vessels supplying the placenta.[3]
Causes and Risk Factors
Common risk factors in the development of uterine atony include uterine overdistention (e.g., polyhydramnios, multiple pregnancy, fetal macrosomia), prolonged labor, prolonged use of oxytocin, chorioamnionitis, and the application of inhaled anesthetic agents.[4]
Differentiating Uterine Atony from other Diseases
Uterine atony must be differentiated from other diseases that cause postpartum hemorrhage, such as obstetrical lacerations, retained placental tissue, placenta accreta spectrum (lacenta accreta, increta, and percreta), uterine inversion, inherited coagulation defects, and disseminated intravascular coagulation (DIC)[5]
Epidemiology and Demographics
References
- ↑ 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.
- ↑ Gill P, Patel A, Van Hook JW. PMID 29630290. Missing or empty
|title=(help) - ↑ Oyelese Y, Ananth CV (March 2010). "Postpartum hemorrhage: epidemiology, risk factors, and causes". Clin Obstet Gynecol. 53 (1): 147–56. doi:10.1097/GRF.0b013e3181cc406d. PMID 20142652.
- ↑ "ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage". Obstet Gynecol. 108 (4): 1039–47. October 2006. doi:10.1097/00006250-200610000-00046. PMID 17012482.