Atony of the uterus, also called uterine atony, is a serious condition that can occur after childbirth. Pdf effect of nursing care protocol on atonic postpartum. Uterine atony is a loss of tone in the uterine musculature. Pdf uterine salvage management for atonic postpartum. Uterine salvage management for atonic postpartum hemorrhage. This study included 160 women of uncontrolled atonic postpartum hemorrhage delivered by cesarean section at ain shams university maternity hospital.
Uterine salvage management for atonic postpartum hemorrhage using modified lynch suture article pdf available in bmc pregnancy and childbirth 161 december 2016 with 120 reads. Postpartum haemorrhage pph prevention, assessment and. Introduction hysterectomy is an operation in which the uterus is removed. Atonic uterus 1124 3 hemorrhage was uterine atony, contributing to 57. Blood vessels in the placental site are surrounded by uterine muscles, which normally contract after delivery and close off the vessels. Prevention and management of postpartum hemorrhage janice m. Hospital total percent uterine atony 36 16 28 80 57.
Primary postpartum haemorrhage management flowchart pdf. The recognised risk factors that are associated with uterine atony are listed in table 1. Table i causes of pph home maternity private hospital govt. Interference with the ability of the uterus to contract. Hysterectomy prepared by dr rajesh t eapen atlas hospital ruwi muscat 2. Hayman stitch which is a simplified approach to uterine compression sutures was performed by tying two. Request pdf uterine compression sutures for atonic bleeding uterine compression suture is a simple and effective hemostatic procedure that requires no special skills. Failure of the uterus to contract atonicuterus results in excessive bleeding. Prevalence and predictors of primary postpartum hemorrhage plos. The cervix, ovaries andor fallopian tubes might also be removed. Atonic uterus bleeding occurs from the placental site after delivery. The other causes of bleeding were retained placenta or its fragments 21.
It occurs when the uterus fails to contract after the delivery of the baby, and it can lead. All the women who were subjected to the hayman stitch for atonic pph were included in the study. Physiological uterine involution in primiparous and. Uterine compression sutures for atonic bleeding request pdf. Normally, contraction of the uterine muscles during labor compresses the blood vessels and reduces flow, thereby increasing the likelihood of coagulation and preventing hemorrhage. The real problem with atonic pph is that you cannot predict who will bleed. Pdf on mar 16, 2012, pei shan lim and others published uterine atony. Pdf postpartum hemorrhage pph is the leading cause of maternal morbidity and. As reported on mothers card, the commonest cause was atonic uterus 5071. Following the development of this protocol, we extracted specific clinical data from the medical records of 10 women who exsanguinated from uterine atony. Note that while you cannot prevent an atonic uterus from occurring nor can you always predict it, knowing the factors that make it more likely will help you to be alert to these possible signs of atonic pph placenta previa or placental abruption.
Hi,my first labour was fine until i gave birth and had an immediate pph. Hayman uterine compression stitch for arresting atonic postpartum. The active management of postpartum uterine atonya. To assess the effectiveness of the new modified technique in order to control bleeding in women presenting with atonic, flabby uterus compared to the most commonly described technique of classic blynch suture. Researcharticle physiological uterine involution in primiparous and multiparous women. Vaginal hysterectomy usually done for some cases of uterine prolapse.
Serum vitamin d deficiency which causes decrease in serum calcium, thereby affecting the contractility of uterine smooth muscle, may result in atonic uterus and. Management strategies 99 and appropriate referral to a wellequipped centre should be done. In the atonic uterus, the vessels especially at the placental bed are unable to contract to. Primary postpartum hemorrhage pph is defined as a cumulative blood loss.