Seminars in Perinatology
Volume 33, Issue 2 , Pages 82-87 , April 2009

Uterine Atony: Definition, Prevention, Nonsurgical Management, and Uterine Tamponade

  • Fionnuala Breathnach, MD, MRCOG, MRCPI

      Affiliations

    • Division of Maternal Fetal Medicine, Columbia University Medical Center, New York, NY
    • Corresponding Author InformationAddress reprint requests to Fionnuala Breathnach, MD, MRCOG, MRCPI, Division of Maternal Fetal Medicine, Columbia University, Medical Center, 622 W 168th Street, New York, NY 10708
  • ,
  • Michael Geary, MD, MRCOG, FRCPI

      Affiliations

    • Department of Obstetrics and Gynecology, Rotunda Hospital, Dublin, Ireland

References 

  1. Cunningham FG, Leveno KJ, Bloom SL. Obstetrical hemorrhage. In:  Cunningham FG,  Leveno KJ,  Bloom SL, et al. editor. Williams Obstetrics. New York: McGraw-Hill; 2005;p. 809–854
  2. Fuchs K, Peretz BA, Marcovici R, et al. The “grand multipara”: Is it a problem? A review of 5785 cases. Int J Gynecol Obstet. 1985;23:321
  3. Babinski A, Kerenyi T, Torok O, et al. Perinatal outcome in grand and great-grand multiparity: Effects of parity on obstetric risk factors. Am J Obstet Gynecol. 1999;181:669
  4. Stones R, Paterson C, Saunders N. Risk factors for major obstetric haemorrhage. Eur J Obstet Gynecol Reprod Biol. 1993;48:15–18
  5. Tsu V. Postpartum hemorrhage in Zimbabwe: A risk factor analysis. Br J Obstet Gynaecol. 1993;100:327–333
  6. Waterstone M, Bewley S, Wolfe C. Incidence and predictors of severe obstetric morbidity: Case control study. Br Med J. 2001;322:1089–1094
  7. Hall MH, Halliwell R, Carr-Hill R. Concomitant and repeated happenings of complications of the third stage of labor. Br J Obstet Gynaecol. 1985;92:732–738
  8. Clark SL, Yeh SY, Phelan JP, et al. Emergency hysterectomy for obstetric hemorrhage. Obstet Gynecol. 1984;64:376–380
  9. Elbourne DR, Prediville WJ, Carrolli G, et al. Prophylactic use of oxytocin in the third stage of labour. Cochrane Database Syst Rev. 2001;4:CD, 001808
  10. In:  Dollery C editors. Therapeutic Drugs. (ed 2). Edinburgh: Churchill Livingstone; 1999;
  11. Parker SL, Schimmer BP. Pituitary hormones and their hypothalamic releasing hormones. In:  Gilman GA editors. The Pharmacological Basis of Therapeutics. (ed 11). New York, NY: McGraw-Hill; 2006;p. 1489–1510
  12. Hunter DJ, Schulz P, Wassenaar W. Effect of carbetocein, a long-acting oxytocin analog on the postpartum uterus. Clin Pharmacol Ther. 1992;52:60–70
  13. Boucher M, Nimrod CA, Tawagi GF, et al. Comparison of carbetocin and oxytocin for the prevention of postpartum hemorrhage following vaginal delivery: A double-blind randomized trial. J Obstet Gynaecol Can. 2004;26:481–488
  14. Dansereau J, Joshi AK, Helewa ME, et al. Double-blind comparison of cabetocin versus oxytocin in prevention of uterine atony after Cesarian section. Am J Obstet Gynecol. 1999;180:670–676
  15. Jacobs M, Arias F. Intramyometrial PGFα in treatment of severe postpartum hemorrhage. Obstet Gynecol. 1980;55:665–666
  16. Oleen MA, Mariano JP. Controlling refractory postpartum hemorrhage with Hemabate sterile solution. Am J Obstet Gynecol. 1990;162:205–208
  17. Bigrigg A, Chui D, Chissell S, et al. Use of intramyometrial 15-methyl prostaglandin F2α to control atonic postpartum hemorrhage following vaginal delivery and failure of conventional therapy. Br J Obstet Gynaecol. 1991;98:734–736
  18. Gulmezoglu AM, Villar J, Ngoc NT, et al. WHO multicentre randomized trial of misoprostol in the management of the third stage of labor. Lancet. 2001;358:689–695
  19. O'Brien P, El-Refaey H, Geary M, et al. Rectally administered misoprostol for the treatment of postpartum hemorrhage unresponsive to oxytocin and ergometrine: A descriptive study. Obstet Gynecol. 1998;92:212–214
  20. Mousa HA, Alfirevic Z. Treatment for primary postpartum hemorrhage. Cochrane Database Syst Rev. 2003;1:CD:003249
  21. Peyser MR, Kupferminc MJ. Management of severe postpartum hemorrhage by intrauterine irrigation with prostaglandin E2. Am J Obstet Gynecol. 1990;162:694–696
  22. Barrington JW, Roberts A. The use of gemeprost pessaries to arrest postpartum hemorrhage. Br J Obstet Gynaecol. 1993;100:691–692
  23. El-Lakany N, Harlow RA. The use of gemeprost pessaries to arrest postpartum hemorrhage. Br J Obstet Gynaecol. 1994;101:277–278
  24. Craig S, Chai H, Cho H. Treatment of severe postpartum hemorrhage by rectally administered gemeprost pessaries. J J Perinat Med. 1999;27:231–235
  25. As AK, Hagen P, Webb JB. Tranexamic acid in the management of postpartum hemorrhage. Br J Obstet Gynaecol. 1996;103:1250
  26. Alfirevic Z, Elbourne DR, Pavord S. Use of recombinant activated factor VII in primary postpartum hemorrhage: The Northern European registry 2000-2004. Obstet Gynecol. 2007;110(6):1270–1278
  27. Aledort L. RFVIIa: Its thrombogenicity. Thromb Haemost. 2000;84:522–523
  28. Peerlinck K, Vermylen J. Acute myocardial infarction following administration of recombinant activated factor VII (novo seven) in a patient with hemophilia A and inhibitor. Thromb Haemost. 1999;82:1775–1776
  29. Roberts H. Clinical experience with activated factor VII: Focus on safety aspects. Blood Coagul Fibrinolysis. 1998;9:S115–S118
  30. B-Lynch C, Coker A, Lawal AH, et al. The B-Lynch surgical technique for the control of massive postpartum hemorrhage: An alternative to hysterectomy? (Five cases reported). Br J Obstet Gynaecol. 1997;104:372–375
  31. Hayman R, Arulkumaran S, Steer P. Uterine compression sutures: Surgical management of postpartum hemorrhage. Obstet Gynecol. 2002;99:502–506
  32. Cho J, Jun H, Lee C. Hemostatic suturing technique for uterine bleeding during Cesarean delivery. Obstet Gynecol. 2000;96:129–131
  33. B-Lynch C. B-Lynch Brace suture (Tech Details). http://www.cblynch.com/HTML/technique.html2003;[updated 2003 Sept 25, 2003; cited]
  34. Treloar EJ, Anderson RS, Andrews HS, et al. Uterine necrosis following B-Lynch suture for primary postpartum hemorrhage. Br J Obstet Gynaecol. 2006;113:486–488
  35. Joshi VM, Shrivastava M. Partial ischemic necrosis of the uterus following a uterine brace compression suture. Br J Obstet Gynaecol. 2004;111(3):279–280
  36. Johanson R, Kumar M, Obhrai M, Young P. Management of massive postpartum hemorrhage: Use of a hydrostatic balloon catheter to avoid laparotomy. Br J Obstet Gynaecol. 2001;108:420–422
  37. Seror J, Allouche C, Elhaik S. Use of Sengstaken-Blakemore tube in massive postpartum hemorrhage: A series of 17 cases. Acta Obstet Gynecol Scand. 2005;84:660–664
  38. Bakri YN, Amri A, Abdul Jabbar F. Tamponade-balloon for obstetrical bleeding. Int J Gynecol Obstet. 2001;74:139–142
  39. Dabelea V, Schultze PM, McDuffie RS. Intrauterine balloon tamponade in the management of postpartum hemorrhage. Am J Perinatol. 2007;24:359–364
  40. Price N, Whitelaw N, B-Lynch C. Application of the B-Lynch brace suture with associated intrauterine balloon catheter for massive hemorrhage due to placenta accreta following second-trimester miscarriage. J Obstet Gynaecol 26:267-268; 2006;
  41. Danso D, Reginald P. Combined B-Lynch suture with intrauterine balloon catheter triumphs over massive postpartum hemorrhage. Br J Obstet Gynaecol. 2002;109:963

PII: S0146-0005(08)00146-8

doi: 10.1053/j.semperi.2008.12.001

Seminars in Perinatology
Volume 33, Issue 2 , Pages 82-87 , April 2009