Uterine atony - Treatment

Treatment of patients with postpartum hemorrhage has two major components:-Resuscitation and control of obstetric hemorrhage and hypovolemic shock-Identify and resolve the cause of bleeding.Resuscitation fluidic women with obstetric hemorrhage is sometimes just conservative.It will raise the legs to improve venous return. Provide oxygen and to obtain a venous access. It manages large volumes of crystalloids: saline or Ringer lactate, cryoprecipitate and fresh blood transfusions.
Uterine atony requiring vigorous massage and administration of oxytocin. Emptying the bladder may help to facilitate uterine contractions and therapeutic maneuvers. If the uterus remains atonic bimanual massage is initiated. A tomorrow is placed on the fundus, and the second previous vaginal cervix. Miina vaginal lubricant is coated or Betadine to slip more easily. The uterus is compressed between the two mind.Massage helps to initiate and sustain contractions.Placenta or clot retention requiring manual uterine exploration and extractionthem. After this maneuver is admnistreaza patient antibiotics.
Surgery is indicated if the uterus remains contracted and bleeding persists despite efforts toturor. Uterine and vaginal message serves as the definitive treatment. Meals are removed 24-48 hours.Laparotomy is rarely indicated. If the abdomen is entered laparoscopically will practice suturing or laser coagulation of bleeding vessels in the placental bed and uterine artery ligation is.Hysterectomy is curative for bleeding.
ComplicationsThe most common problems with iron deficiency anemia in postpartum fatigue. It may be possible damage to major organs and body systems: respiratory distress, acute renal failure. Pregnant women are at risk of venous thrombosis and embolic events.Many of the other risk factors predisposing to venous thrombosis comprising a vaginal delivery, cesarean birth and pelvic surgery. Shock due to venous stasis and immobility also contribute.
Hypopituitarism after severe hemorrhage (Sheehan syndrome) is due to critical ischemia of hypertrophied hipopituitarei. The condition should be suspected if there is breastfeeding.
Complications also include sterility, uterine perforation, uterine synechiae, urinary tract lesions, genitourinary fistula, sepsis and pelvic hematoma.
Prevention:Data from studies suggest that active control of stage 3 of labor reduce the incidence and severity of uterine atoniei. Active Control contains a combination of uterotonic administration (preferably oxytocin) immediately after birth, clipping and cutting the cord fast, gentle cord traction with uterine contratractiune when the uterus is well contracted (Brandt-Andrews maneuver).Rapid recognition and diagnosis of uterine atoniei effective control is essential.Resuscitation measures with diagnosis and treatment of the case must intervene before the onset of hypovolemia sequelae.