OBSadvanced
Describe the management options for uterine atony that persists despite medication.
Answer
Continue resuscitation and monitoring; consider bimanual uterine compression and external aortic compression as temporary measures; proceed to uterine tamponade, compression sutures such as B-Lynch, uterine or internal iliac artery ligation, embolization where available, or hysterectomy if required.
Explanation
The slides describe temporary compression while preparing definitive intervention, followed by conservative surgical measures, vessel procedures, embolization, and hysterectomy. Blood and fluid treatment and continuous monitoring continue during escalation. **Key takeaway:** Do not allow repeated failed medical treatment to delay definitive control.\n\n**Glossary:** **B-Lynch suture**: a uterine compression suture used to control atonic bleeding.
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