What is Atonic Uterus?

The birthing process is divided into three stages

1. The time when you go into labour till your cervix (mouth of your uterus) dilates
2. The actual birth of your baby
3. When your placenta separates from the mouth of your uterus

All the while, the muscles of the uterus expand and contract to push the baby out. Normally, in the third stage, the muscles of the uterus contract and the placenta is shed out of the wall of the uterus.

When the muscles contract, it seals off the bleeding from your uterus.

However, sometimes, the uterus fails to contract and becomes relax. This is called an atonic uterus. Here, you continue to bleed, which could lead to a haemorrhage and even death.

You could have an atonic uterus if;

• You have a prolonged labour, then the muscles of the uterus tend to go limp and stop contracting.
  
• Yours is a multiple pregnancy; the uterus might get over-expanded.
  
• You have a big baby. The uterus gets over-expand and leads to atonic uterus. This is especially common with diabetics.
  
• You have hypertension or high blood pressure, then placental abruption occurs and leads to haemorrhage.

What's the Solution?

Normally, after delivery, an injection is administered in your uterus. The uterus is then massaged to help the muscles contract and prevent it from turning atonic.

At times, despite of the injection, the uterus does not stop bleeding. In such cases, doctors pack the uterus and compress the placental side.

In severe cases, a hysterectomy (removal of uterus) is done. Another option is a procedure in which a small pellet is inserted into the uterus, through radiology.

However, do not worry; just keep your blood pressure and diabetes under control and everything should fall into place.

(Inputs from Dr. Kiran Coelho, gynaecologist)