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articles bleeding relationship with atonia uteri

CHAPTER I

INTRODUCTION

A. ac!ground

As a "elatarbela!angi this paper is to discuss about # atonia Uteri # is so we can

$nd out what the atonia uteri and how codes o% the atonia uteri . This paper is

"ade so that students understand "ore about the "eaning & causes& and wa's

o% handling atonia uteri .

Atonia uteri was the cause o% "ost childhood pospartu" bleeding ( )* + , & and

is the "ost %re-uent reason %or doing a h'sterecto"' postpartu" . Contractions

o% the uterus is the pri"ar' "echanis" to control bleeding a%ter childbirth .

Atonia occurred because o% %ailure o% this "echanis" . Pospartu" ph'siologic

bleeding is controlled b' $ber $ber contractions o% the "'o"etriu"

surrounding the blood /essels o% the placenta i"plantation "e"/as!ularisasidistrict . Atonia uteri occurs when the $ber $ber non contracting "'o"etriu"

Uteri atonia is a condition in which the "'o"etriu" can not contracting and

when this happens the blood co"ing out o% the container to attach the placenta

beco"es uncontrolled . ( Apri & 0**1,.

. 2u""ar' o% Proble"s

3 . E4plaining the "eaning o% atonia uteri

0 . 5actor e4plaining the cause o% the atonia uteri

6 . e4plain the occurrence o% signs and s'"pto"s o% atonia uteri

7 . E4plaining how it handles or codes o% atonia uteri

C. Purpose o% 8riting

3 . 9nowing and understanding about atonia uteri

0 . Adding !nowledge o% atonia uteri

6 . :et to !now about the "eaning & etiolog' & %actors cause & and also codes o%

atonia uteri .

CHAPTER II

DISCUSSION

2.1 Atonia understanding uteri

Uterine atony is defined as a condition in te fai!ure of te uterus to contract "ro"er!y after

de!i#ery $ %ereas atonic uterus is a!so defined as te a&sence of uterine contractions

i''ediate!y after de!i#ery of te "!acenta .

(ost of te &!eeding in te "uer"eriu' ) *+,- / 0 is due to uterine atony . As %e no% tat

utero"!acenta! &!ood f!o% during "regnancy is +,- '! 'in $ so %e can i'agine tat

%en te uterus does not contract for a fe% 'inutes$ it %i!! cause te !oss of so 'uc &!ood .

3i!e te u'an &!ood #o!u'e is on!y a&out +,4 !iters .

2.2 . 5actors Causing Occurrence of uterine atony

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Se#era! factors associated %it "redis"osition "ost"artu' e'orrage caused &y uterine

atony $ %ic are6

1 . En!arged uterus 'ore tan nor'a! during "regnancy $ inc!uding 6

7 e8cessi#e a'ount of a'niotic f!uid ) Po!yydra'nios 0

7 Pregnancy 9e'e!!i

7 !arge fetus ) 'acroso'ia 02 . Stage one or stage t%o e!ongated

: . 5ast de!i#ery ) "arturition Preci"itate 0

; . 2 years and ? :+ years 0

Uterine atony can a!so arise due to incorrect and!ing of tird stage of !a&or $ &y 'assaging

te uterus and "us it do%n in an atte'"t to de!i#er te "!acenta $ %as in fact not &e se"aratedfro' te uterus

2.: Te signs and sy'"to's of uterine atony

Signs and sy'"to's of uterine atony are 6

#agina! &!eeding

@!eeding tat occurs in #ery 'any cases of uterine atony and &!ood does not see" . 3at

often a""ens is tat te &!ood c!ot out %it $ tis a""ens &ecause te tro'&o"!astin is no

!onger as an anti, &!ood c!otting .

Consistency soft uterus

Tis "eno'enon is an i'"ortant sy'"to' caracteristic tat distinguises atonia atonia

and %it oter causes of &!eeding .

5undus ride

Caused &y &!ood tra""ed in te uterine ca#ity and agg!o'erate

Tere are signs of soc

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(assage sti'u!ates uterine contractions . 3en do "eni!aia di'asase uterine contractions

2 C!ean te &!ood c!ot adan #aginadan "it 'e'&ranes of te cer#i8

@!ood c!ots and 'e'&ranes in te #agina and cer#ica! cana! %i!! &e a&!e to &!oc &ot uterinecontractions .

: (ae sure tat te &!adder is e'"ty $ if fu!!y "a!"a&!e $ do cateteri=ation using ase"tic

tecniBue fu!! &!adder %i!! &e a&!e &!oc te uterus to contract "ro"er!y .

; Perfor' &i'anua! Interna! ) @I 0 for + 'in interna! &i'anua! co'"ression gi#es direct

"ressure on &!ood #esse! %a!!s uterusdan a!so sti'u!ates te 'yo'etriu' to contract .

+ Encourage te fa'i!y to &egin to e!" te fa'i!y of e8terna! &i'anua! co'"ression can

for%ard an e8terna! &i'anua! co'"ression during e!"er do te ne8t ste"s

4 Re'o#e and s!o%!y A#oiding "ain

* 9i#e ergo'etrin .2 'g I( ) contraindicated y"ertension 0 or 4,1 'cg 'iso"ostro!

Ergo'etrine and 'iso"ostro! %i!! %or in +,* 'inutes and causes uterine contractions- Re"!ace infusion using a need!e 14 or 1- and gi#e +cc Ringers !actate 2 units of

o8ytocin . S"end te first + cc ASAP !arge need!es a!!o% ra"id ad'inistration of I

so!ution or &!ood transfusion . R< %i!! e!" restore te #o!u'e of f!uid !ost during

"erdaraan.ositosin I %i!! Buic!y sti'u!ate uterine contractions .

F Re"eat @I interna! &i'anua! co'"ression is "erfor'ed in conGunction %it o8ytocin or

'iso"ostro! ergo'etrin and %i!! 'ae te uterus contract

1 Refer i''ediate!y if te uterus is not &erontasise!a'a 1 to 2 'inutes $ it is not a si'"!e

atony . (oters needing e'ergency treat'ent at a faci!ity tat is a&!e to carry out te surgery

and &!ood transfusion

11 5aci!itate te 'oter to te "!ace of reference . Continue doing tis uterine co'"ression

@I indirect!y "ut "ressure on te &!ood #esse! %a!!s of te uterus and sti'u!ate te uterus to

contract

Continue 2 12 IU o8ytocin infusion R< in + cc of so!ution at a rate of + cc our so

s"ent 1.+ I infusion . Ten gi#e 12+ cc our . If tere is not enoug !iBuid $ gi#e + cc of

te !atter at a 'oderate "ace and "ro#ide drin for reydration R< can e!" restore f!uid

#o!u'e !ost due to &!eeding . O8ytocin can sti'u!ate te uterus to contract .