Single Best Answer (SBA) · Postpartum Haemorrhage and Third-Stage Complications
A clinician lists causes of uterine atony. Which single factor is a recognised cause of atonic PPH?
Show answer and explanation
Answer: B. Multiple gestation (over-distension of the uterus)
Causes of uterine atony
Atony results from anything that over-distends or fatigues the uterus or impairs its contraction.
Recognised causes
- Over-distension: multiple gestation, fetal macrosomia, polyhydramnios.
- Fatigue: prolonged labour; also rapid (precipitate) or induced labour.
- Retained placenta/products, contraction-inhibiting drugs, bacterial toxins (infection), hypoxia, Couvelaire uterus (in abruption), hypothermia, and grand multiparity.
This case
- Multiple gestation over-distends the uterus, impairing effective retraction and predisposing to atony.
Recognising these allows anticipation and active management to prevent PPH.
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