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

Etiology

Pathophysiology

Clinical features

Diagnostics

Treatment

• 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