For nine months, your developing baby is fed by your uterus. Many of the blood veins in your uterus burst after your baby is born. Your uterus's muscles tighten and seal themselves together.

When the muscles fail to contract, uterine atony transpires, permitting the bleeding to persist. A medical emergency has occurred. One can die from uterine atony.

What Is Uterine Atony?

The blood arteries in your uterus provide oxygen and nourishment to your developing baby during pregnancy. Your unborn child receives blood via spiral arteries, which grow throughout pregnancy.

These spiral arteries remain fractured after delivery. The myometrium, or muscles, of your uterus contracts, squeezing them shut. If they don't, uterine atony could happen and result in significant blood loss.

One known side effect of both vaginal birth and cesarean surgery is uterine atony. It can also happen following medical abortions and miscarriages.

What Causes Uterine Atony?

Your pituitary gland releases oxytocin shortly after delivery. This hormone halts the bleeding by inducing contractions in the uterus.

The uterine muscles' inability to contract is the fundamental cause of uterine atony.

What Are the Risk Factors for Uterine Atony?

You have an increased risk of getting uterine atony if certain parameters are met. Among them are:

• a protracted and challenging labor
• extreme uterine stretching, which can occur with numerous births, particularly large kids, or excessive water retention (polyhydramnios).
• prolonging the induction of labor with oxytocin 
• using medication such as magnesium sulfate
• obesity Having chorioamnionitis, or an infection of the membranes surrounding the fetus, having fibroids, or benign growths in the uterus

What Are the Symptoms of Uterine Atony?

An extended period of uterine bleeding is the main indicator of uterine atony. You could lose a significant volume of blood as a result of this.

After delivery, some bleeding is normal. However, you should notify your doctor if you feel like you're bleeding profusely or need to change your pads regularly. Significant blood loss can result in:

• Low blood pressure (hypotension)
• Fast heartbeat
• Pale appearance
• Reduced urination
• Dizziness
• Unconsciousness

How Is Uterine Atony Diagnosed?

Your uterus's feel and size will help your doctor make the diagnosis of uterine atony. After closing the incision, your doctor will feel your uterus if you had a cesarean section to deliver your baby. Your doctor will perform a vaginal examination if you give birth vaginally.

The uterus often shrinks and contracts shortly after birth. Uterine atony is characterized by a big, mushy uterus.

Atony might occasionally solely impact the bottom portion of the uterus. The fundus, or upper portion, could feel normal. If the fundus feels normal, your doctor may concentrate on this lower area in addition to feeling the entire uterus for the typical softness associated with uterine atony.

Uterine atony is the primary cause of around 75% of postpartum hemorrhage, or excessive bleeding following childbirth. To be sure, your physician might additionally check you for:

• Uterine, vaginal, or cervix tears
• Placenta incomplete delivery, which can also result in severe hemorrhage

What Is the Treatment for Uterine Atony?

Urgent care is required for uterine atony. You might require one or more blood transfusions to recover once the blood loss is halted. If your blood pressure is low, your doctor might also administer oxygen, intravenous infusions, and other medication therapies to you. This may consist of:

• Oxytocin (Pitocin). Usually given slowly in an intravenous infusion, oxytocin stimulates the uterine muscles so they'll contract. This squeezes the uterine spiral arteries and stops the bleeding.
• Methylergonovine (Methergine). This drug can reverse the atony and stop blood loss. Your doctor won't use it, though, if you have hypertension (high blood pressure).
• 15-methyl-PGF2, misoprostol, and dinoprostone. These are prostaglandins, or chemicals that have biological actions. They're given as injections or as vaginal or rectal suppositories.
• Surgery. If you're losing blood even after medical treatment, your doctor may use surgical methods, including:
  • Uterine packing with gauze. This method tries to stop the bleeding of uterine atony by applying direct pressure on the bleeding arteries.
  • Uterine balloons. Special balloons are placed into your uterus and inflated with air or saline solution. This method also relies on direct pressure.
  • Uterine artery ligation. Your doctor ties off the artery that carries blood to the uterus. This will stop the blood loss. Your doctor may have to do this if other methods have failed.
  • Hysterectomy. If nothing else stops the bleeding, your doctor may have to remove your uterus to save your life. This major surgery is called a hysterectomy and is only done as a last resort. After a hysterectomy, you can't have babies again.