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Option 1 : Massage the uterus
Concept:
- Atonic -> Means loss of muscular tone to contract.
- Atonic PPH -> Excessive bleeding occurs when the uterus is not well contracted after delivery.
- And uterus becomes soft, distended and lacking muscular tone.
Explanation:
- Causes of atonic PPH:
- Retained placenta or remnants of placental tissue/retained amniotic membranes or blood clots.
- Prolonged exposure to oxytocin during induction of labor.
- Prevention and Management:
- Priority action is uterine massage
- Oxytocin and Ergometrine administration
- Manual removal of the placenta
- Sometimes, prolonged exposure to oxytocin also leads to uterine atony.
- Prior to medication administration, uterine massage is done.
- Ergometrine and oxytocin stimulate the uterus to contract.
- These drugs are administered during induction of labor or after delivery of anterior shoulder or soon after delivery of the baby.
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