The concept of atony refers to the lack of strength or energy. The term is often used in medicine to refer to weakness of muscles or tissues.
The uterine inertia, in this context, is the loss of vigor of the muscles of the uterus, a feature that prevents contraction of the organ. This atony causes that, after childbirth, the uterus does not contract as it should to close the blood vessels.
At the time of delivery, when the woman delivers the baby and delivers the placenta, a process of uterine contraction begins to develop that minimizes postpartum bleeding. If the mechanism is not carried out, uterine atony is generated with profuse bleeding and the appearance of clots and bruises that cause pain to the woman. As if this were not enough, the lack of intervention in a case of uterine atony can lead to death.
Among the reasons that can cause uterine atony are the following according to DigoPaul:
* lack of oxytocin, the hormone secreted by the organ called the pituitary gland to help with the contraction of the uterus and the rise in milk;
* multiple pregnancies. This has been proven through various statistics, since in such a case the uterine fiber must acquire a greater elasticity than necessary to deliver a single baby;
* large babies, a phenomenon that has consequences similar to those of the previous point;
* placental accreta, the abnormal adherence of the placenta to the wall of the uterus. It has been observed that in this problem it is very difficult to extract the placenta;
* history of this same disorder;
* late delivery of the placenta, that is, when the delivery of the fetal appendages and the placenta takes more than 20 minutes. This can happen for a number of reasons, such as the baby is not very full term and the placenta is too attached to the uterus to prevent it from falling out.
* a very long labor, a multiple pregnancy causing excessive distention and the presence of a benign tumor known as a fibroid.
It is important to note that it is not possible to prevent uterine atony before delivery, and for this reason immediate intervention is invaluable. This does not mean that the experience of the professionals helps them to intuit the presence of this complication, but in general they do not have much time to act.
Many hospitals have opted for targeted delivery, which involves administering a drug to the mother as soon as the baby has left the uterus, to promote contraction. Since atony does not always appear as soon as the delivery has occurred, it is also normal to monitor the mother for a minimum of two hours, until making sure that the constants have normalized.
To treat atony, it is possible to resort to massages, the supply of drugs (such as exogenous oxytocin) or a surgical intervention, depending on the case. The massage is the first step that sets the protocol to react to abnormal bleeding, and is carried out by rubbing the casing; it can also be combined with one from inside the uterus, in what is known as the bimanual maneuver.
The atony can also be gastrointestinal (generally as the effect of an operation), bladder (consequence of anesthesia, to name one possibility) or of another type.
Beyond medicine, the idea of atony is used as a synonym for apathy or lack of will: “Adolescent atony worries psychologists”, “When I was fired, I was lying in bed for several months, victim of atony”.