Although uterine atoniei manifestations are usually dramatic, bleeding can be slow, yetcritical, leading to shock. This phenomenon is more common in secondary bleeding orretained tissue trauma. The bleeding usually presents as a massive loss of blood whichquickly lead to vaginal signs and symptoms of hypovolemic shock. This loss reflects the combination of rapid blood flow and increased uterine most common cause of bleeding,uterine atony. Loss of blood is visible at introitus is true if the placenta was removed, if the placenta was not removed when it can be a massive amount of blood retained in theuterus behind a partial placenta removed.
Even after elimination of placental blood can accumulate in an atonic uterus. For thisreason uterine size and tone should be monitored in the third period after birth. Uterinefundus is palpated easily. If due to uterine atony singerarii is not, then bleeding can beslow and the signs and symptoms of hypovolemia can develop into a long period of time. Bleeding may occur as the trauma of retroperitoneal hematoma, broad ligament orlower genital tract or abdominal cavity.
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