Postpartum uterine atony

Weingarten AE, Korsh JI, Neuman GG, Stern SB. Postpartum uterine atony after intravenous dantrolene. Anesth Analg 1987 66(3) 269-70. 

Oxytocin (0.5 miUiunits/min) is indicated to induce term labor, to control postpartum hemorrhage, to prevent postpartum uterine atony, to expel the placenta, and to prevent postpartum breast engorgement. 

Uterine artery embolization (UAE) is an established technique that has been used to stop life-threatening vaginal hemorrhage in women with malignancy, postpartum uterine atony, or traumatic injury since the mid-1970s [8,18,52,64,112]. The first successful treatment of symptomatic fibroids of the uterus by UAE was reported by Ravina et al. in 1994 [150]. 

Ergonovine and methylergonovine both increase the strength, duration, and frequency of uterine contractions and decrease the incidence of uterine bleeding. They are given after the delivery of the placenta and are used to prevent postpartum and postabortal hemorrhage caused by uterine atony (marked relaxation of the uterine muscle). 

It increase force, frequency and duration of uterine contractions. It is used to control and prevent postpartum haemorrhage. It is also used to prevent uterine atony after cesarean or instrumental delivery. 

Before delivery, oxytocin is usually administered intravenously via an infusion pump with appropriate fetal and maternal monitoring. For induction of labor, an initial infusion rate of 0.5-2 mU/min is increased every 30-60 minutes until a physiologic contraction pattern is established. The maximum infusion rate is 20 mU/min. For postpartum uterine bleeding, 10-40 units are added to 1 L of 5% dextrose, and the infusion rate is titrated to control uterine atony. Alternatively, 10 units of oxytocin can be administered by intramuscular injection after delivery of the placenta. 

Hayashi RH, Castillo MS, Noah ML. Management of severe postpartum hemorrhage due to uterine atony using an analogue of prostaglandin F2 alpha. Obstet Gynecol 1981 58(4) 426-9. 

Carboprost is a 15-methylated analogue of PGF2a- It is used in termination of pregnancy, in the management of labor, and to treat postpartum hemorrhage and uterine atony. 

Routine management after delivery of the placenta, uterine atony, and hemorrhage Antepartum to initiate or improve uterine contractions postpartum to produce uterine contractions in third stage of labor, control of postpartum bleeding and hemorrhage... 

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