Failure of the uterus to effectively contract after complete or incomplete delivery of the placenta, which can lead to severe postpartum bleeding from the myometrial vessels

Epidemiology

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Etiology

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Pathophysiology

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Clinical features

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Diagnostics

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Treatment

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• Hemorrhage control
  • Uterotonic agents
    • IV oxytocin (diluted in saline)
    • IM methylergonovine: if no hypertension or arterial disease is present
      • Ergot alkaloid agent
      • Increases frequency and amplitude of uterine contractions, which shortens labor and reduces blood loss
      • Contraindications include pre-existing hypertension and preeclampsia
    • Prostaglandins such as misoprostol: useful when injectable uterotonic agents are unavailable or contraindicated (can also be given intracavitary)
  • Tranexamic acid
    • Given concomitantly with uterotonic agents