UTERINE ATONY
Uterine atony is the most common cause (80%) of excessive postpartum
bleeding.
Risk Factors. Rapid or protracted labor (most common), chorioamnionitis,
medications (e.g., MgSO 4 , β-adrenergic agonists, halothane), and overdistended
uterus.
Clinical Findings. A soft uterus (feels like dough) palpable above the umbilicus.
Management. Uterine massage and uterotonic agents (e.g., oxytocin,
methylergonovine, or carboprost).