Atonic uterus contraction seen in all EXCEPT
(IUGR): (213, 410-11- Dutta 7th edition)Atonicity of the uterus is the commonest cause of post partum haemorrhage (80%)Causes of PPH* Atonic Uterus (80%)* Traumatic (20%)- Grand multipara* Retained tissues (Bits of placenta, blood clots causes PPH due to imperfect uterine retraction)- Over distension of the uterus- Malnutrition and anaemia- APH* Drugs - tocolytic drugs (ritodrine) MgSO4, Nifedipine- Prolonged labour- Anaesthesia* Blood coagulation disorders - are abruptio placetae, Jaundice in pregnancy, Thrombo cytopenic purpura, HELLP syndrome or in IUD- Indication or augmentation of delivery by oxytocin- Malformation of the uterus- Uterine fibroid- Mismanaged third stage of labour- Placenta (accreta, percreta) constriction ring uterus- Precipitate labourPPH is due to uterine atony during labour in polyhydromnios (213-Dutta 7)
Multiparity
IUGR
Polyhydramnios
Prolonged labour
Miscellaneous (Gynae)