🤱 Postpartum Hemorrhage & Uterotonic Treatment Simulator

Uterine Atony — The Leading Cause of Postpartum Hemorrhage

Loss of myometrial tone prevents natural vessel clamping after birth.

• ~70%: PPH cause share (Placeholder statistic)
• <1 min: Normal tone onset (Placeholder statistic)
• 12+: Risk factor count (Placeholder statistic)
• Soft/boggy: Fundal check (Placeholder finding)

Mechanism of atony

Overdistended or exhausted uterine muscle fails to contract.

Placeholder callout: early fundal massage detects atony fast.

Continued Bleeding from the Placental Implantation Site

Without contraction, spiral arteries continue to hemorrhage freely.

• 500-1000 mL/min: Flow rate (Placeholder statistic)
• Minutes: Time to shock (Placeholder statistic)
• Spiral arteries: Vessel type (Placeholder detail)
• Steady flow: Detection cue (Placeholder finding)

Why bleeding persists

Vessels stay open until myometrial fibers compress them shut.

Placeholder callout: quantify blood loss early and often.

Oxytocin — First-Line Uterotonic Therapy

Oxytocin receptor binding drives rhythmic myometrial contraction.

• IV infusion: Route (Placeholder detail)
• ~1 min: Onset (Placeholder statistic)
• First-line: Guideline status (Placeholder detail)
• ~80-90%: Response rate (Placeholder statistic)

Oxytocin mechanism

Receptor activation raises intracellular calcium, triggering contraction.

Placeholder callout: oxytocin is standard prophylaxis and treatment.

Second-Line Uterotonics — Methylergonovine and Misoprostol

Added when oxytocin alone fails to achieve adequate tone.

• IM route: Methylergonovine (Placeholder detail)
• Rectal/oral: Misoprostol (Placeholder detail)
• Hypertension: Contraindication (Placeholder caution)
• ~95%: Combined success (Placeholder statistic)

Escalation logic

Stepwise addition of agents targets different receptor pathways.

Placeholder callout: check blood pressure before ergot agents.

Bimanual Uterine Massage — Mechanical Adjunct

Manual compression buys time while pharmacologic agents take effect.

• Two-hand compression: Technique (Placeholder detail)
• Until tone returns: Duration (Placeholder detail)
• Bridge therapy: Adjunct role (Placeholder detail)
• Improved hemostasis: Combined effect (Placeholder finding)

Manual compression

External and internal hand compress uterus against sacrum.

Placeholder callout: massage complements, not replaces, drugs.