Distinguishing RPOC from natural postpartum lochia or uterine
atony is not easy.
Uterine
atony was the most common reason for EOH in this study, followed by morbidly adherent placenta.
In a study, packing was performed due to postpartum bleeding associated with uterine
atony but hypogastric artery ligation was not performed in one of three patients in whom the Kittipat method was performed (11).
One of our subject end up in uterine
atony and surgical treatment was opted.
Koenen et al., "Carbetocin in comparison with oxytocin in several dosing regimens for the prevention of uterine
atony after elective caesarean section in the Netherlands," Archives of Gynecology and Obstetrics, vol.
Although uterine
atony following a spontaneous vaginal delivery is the most frequent reason for PPH, other pregnancy-related emergent conditions may also lead to rapid blood loss [1].
The predominant cause of MT was uterine
atony (mostly due to multiple gestation, uterine leiomyomas, and chorioamnionitis) throughout the 10-year period, which accounted for 55% of the MTs, followed by placental abnormalities (placenta previa, placenta accreta, and placental abruption) at 29%, laceration (uterine rupture) at 11%, and coagulation dysfunction (amniotic embolism) at 5%.
In grand multiparas due to decrease in muscular tissues and increase in fibrous tissues of uterus, uterine
atony is more common.
PP with or without PA and uterine
atony were the main cause of PPH in this study, as well as in control groups.
It is generally caused by four major conditions- tone (uterine
atony), trauma, tissue (retained placenta), Thrombin (coagulopathy).
At the pathological level, the causes of excessive bleeding at CD are uterine
atony (commonly after prolonged labour), uterine trauma (excessive bleeding from uterine incision or additional tears laterally into the broad ligament or vertically down the lower segment) and placental site bleeding (associated with placenta praevia, previous CD and/or morbidly adherent placenta).
Uterine
atony is the most common cause of PPH (70%), but genital tract trauma (i.e.