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Uterine Atony - Reasons, Signs, and Treatment
Uterine atony or atony of the uterus is a serious condition that can happen after childbirth. Uterine atony is a life-threatening condition and can result in maternal death. Immediate treatment is required if a woman goes experiences this condition. Read on to know more about this condition.
What Is Atony of the Uterus?
Uterine atony, in medical terms, means the loss of tone in the uterine musculature. During labour, uterine muscles contract compressing the blood vessels and reducing the blood flow. This, in turn, increases the likelihood of coagulation and prevents haemorrhage. But when the uterus fails to contract after the delivery, it is known as atony of the uterus and this can lead to postpartum haemorrhage. It has been proved that 75%-80% of postpartum haemorrhages are due to uterine atony.
Causes of Uterine Atony
There are many factors which prevent the muscles of the uterus from contracting after labour. Some of the most common causes of uterine atony are mentioned below.
Prolonged labour or delayed labour
Rapid labour
Overdistention of the uterus (enlargement of the uterus) because of the presence of excess amniotic fluid ( a condition called as polyhydramnios) or a large baby
Administration of oxytocin, general anaesthesia or other drugs during labour
Inducing labour using medication
There is a potential for an increased risk of the atony of the uterus if the below-mentioned factors exist -
Multiple pregnancies or delivering twins or triplets
Have had many previous deliveries
Fetal macrosomia where the baby is larger than average
If delivery was assisted using forceps or vacuum
You are over 35 years of age
You are medically classified as obese
The factors mentioned above are some of the causes which pose a risk of postpartum haemorrhage according to their severity. The risk for uterine atony is not the only cause of postpartum haemorrhage; it could occur in women who have had no risk factors at all.
Signs and Symptoms of the Uterine Atony
The most common and foremost symptom of uterine atony is that the uterus remains relaxed and without any tension after giving birth. Atony of the uterus is the primary cause of postpartum haemorrhage. Postpartum haemorrhage is excessive bleeding post-delivery and occurs after the placenta is delivered. About 1%-5% of women have a postpartum haemorrhage, and a loss of more than 500 millilitres of blood after delivery of the placenta is defined as postpartum haemorrhage. With most haemorrhages occurring right after delivery (especially in caesarean births), the symptoms include:
Uncontrollable and excessive bleeding post-delivery of a baby
A drop in blood pressure
An increase in the heart rate
Pain
Back pain
Diagnosing Atony of the Uterus
Uterine atony is diagnosed when the uterus is soft, relaxed and there is an excess bleeding post giving birth to a baby. A doctor may be able to estimate the loss of blood by counting the number of saturated pads or weighing the sponges that are used to absorb blood. A physical examination by the doctor will help rule out other causes of bleeding like a tear in the cervix or pieces of the placenta in the uterus. The doctor will also keep a watch for the following.
Pulse rate
Blood pressure
Count of red blood cells
Factors for clotting of blood
Complications
Apart from insufficient uterine contraction, other complications of uterine atony include -
Giddiness, dizziness, or light-headedness, due to low blood pressure generally termed as orthostatic hypotension
Anaemia
Fatigue and tiredness
Anaemia or fatigue after birth increases the chances of a mother experiencing postpartum depression. An uncontrolled and excessive loss of blood than the normal could lead to hemorrhagic shock. If blood loss is not monitored, then it could lead to a life-threatening situation.
Treatment
The first treatment is intended to stop the bleeding and replace the blood that has been lost. Medical experts ensure that the mother is given IV fluids, blood and blood products without any delay.
Other modes of treatment include:
A uterine massage, where the doctor places one hand in the vagina pushing against the uterus with the other hand over the abdominal wall compressing the uterus.
Prescribed uterotonic drugs including oxytocin, methylergonovine and prostaglandins
Blood transfusions
In cases where the condition is severe, treatment includes
A surgery to tie the blood vessels.
Uterine Artery Embolization - It involves injecting minute and small particles into the uterine artery to impede blood flow to the uterus.
Hysterectomy, if all other treatments fail
Outlook for the People With Uterine Atony
Countries with limited healthcare facilities have higher death instances caused due to postpartum haemorrhage. The risk of death increases due to delay in diagnosis, delay in access to a medical facility and delay in receiving the recommended treatment. If the diagnosis and treatment happen on time, there is a less likelihood of complication.
Can Uterine Atony Be Prevented?
No, uterine atony cannot be prevented, but a doctor can help manage the condition through all the stages of labour. If there is a presence of risk, then appropriate uterine atony nursing management procedures must be in place. The medical facility should have IV lines ready, prescribed medications handy, and the equipment to deal with blood loss.
Vital signs of the amount of bleeding occurred after birth must be monitored by the doctor to detect haemorrhage. Oxytocin is the first line of treatment suggested to help the uterus contract after delivery. Uterine massage has now become a common practice post-delivery of the placenta to reduce the risk of symptoms of uterine atony. Taking a regulated dose of prenatal vitamins and iron supplements can also help in preventing anaemia and other complications of postpartum uterine atony.
Uterine atony is the main cause of primary postpartum haemorrhage, a condition marked by excessive bleeding. Scheduled and constant monitoring of the patient, access to a well-equipped hospital, availability of blood, blood products, drugs and the presence of competent medical staff at the time of delivery is vital for the diagnosis and prognosis of uterine atony.
Also Read: Complications during Labour and Delivery Read more
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25 Unique Gift Ideas for Your Child's Nanny or Babysitter
Entrusting your child's responsibility to a caregiver is no joke, and the peace of mind that follows after you find a great babysitter is priceless. If you have a nanny or babysitter who helps you maintain the sanity and stability in your life, then they surely deserve a token of appreciation. Be it any occasion, such as Mother's Day, their birthday, or when bidding them farewell, personalized nanny gifts could make it even more memorable. From lab-tested items to personalized goodies, there is so much you can gift to a nanny or babysitter. All you need to do is pick the right gift for the right occasion.
Top Babysitter and Nanny Gifts to Make Them Feel Loved
The people who look after your kids to bring stability to your lives-nannies, daycare staff, or babysitters need to know how much they are appreciated. When it comes to treating the babysitter, gift ideas may seem restricted. But gifting something thoughtful shows how much you care. Nannies invest a lot of their own lives in your children. From wiping tears, accompanying your child to play dates, cleaning bottoms, preparing meals, and keeping the house together when you return home, a personal gift can acknowledge the importance of their presence in your lives. They choose to spend every minute of their lives with your kids and become a part of your family.
Gifts for babysitters or nannies must be specially handpicked to appreciate their contribution. We have shortlisted 25 nanny gift ideas that could be perfect for your child's babysitter.
1. Scented Candles
If your babysitter is making your home smell like fresh flowers because of the impeccable order in the house, they deserve to be gifted some scented candles that will fill their home with a fragrant aroma. If you want to give your kids' nanny birthday gifts, options like scented candles could make them feel elated. There are so many available in the market ranging from varied scents to a natural fragrance, that your nanny will instantly love the gift.
2. Tuxedo Robe
A gift for a nanny leaving after several years of looking after children, this tuxedo robe is ideal for the nanny hanging her boots and embracing retirement. These can be perfect for slipping into and enjoying those retirement mornings, sipping a cup of tea, and gazing into the wilderness. You could get one in silk that will feel smooth and cozy too.
3. Coffee Mug
Another one of the best nanny Christmas gifts would be a coffee mug that they can use at all times. What better than a personalized coffee mug with a personalized message that will make their morning brew stronger!
4. Keychain
Keychains are versatile gifts. They are multifunctional- car keys, house keys, or just hanging for ornamental value on bags, keychains make an excellent gifting option. Pick a nice one that suits your nanny's style, and they could proudly flaunt it.
5. Oversized Hoops
Ultra-flattering and great for everyday wear, you can gift oversized hoops in 14-carat gold without making it look like an over-the-top gift. If your nanny likes to sport a trendy pair of earrings, then these could be the best gift for them to accessorize when they are out and about.
6. Makeup Bag
A personalized makeup bag in leather or fabric could be a wonderful gift if you have a female nanny. A classic and sophisticated gift, it could be the solution for their makeup woes. It could also prove helpful if your nanny loves traveling since this could serve as a one-stop solution to carry their makeup essentials.
7. Perfume
Perfumes are a delightful gift that no one will not like. No nanny would not appreciate a nice bottle of perfume that could be put on when they are going out for a party or get-together. You could pick a limited edition of a branded perfume or a set of bottles in small sizes for them to choose different fragrances for different occasions.
8. Skin Care Kit
Indulge your nanny or babysitter with a limited edition of an essential skincare kit. Generally, these kits come with a body scrub, face scrub, body lotion, and hand lotion enriched with rich oils and ingredients that are wonderful for the skin.
9. Sunglasses
One could never go wrong with a bright pair of shades. If you have a male babysitter, then these could be the best choice. Which man would not like a classy pair of Aviators? A female nanny would also love a pair of sunglasses that will go with all outfits.
10. Coasters
You get a range of coasters, from hand-carved ones to digitally printed ones that could adorn their dining table. Pick ones with their initials or a pretty design to lend it a personalized touch.
11. Tote Bag
Your nanny has plenty to carry, and between her stuff and things for your kids, she may have to trade off a few things if her bag is not big enough. Help her to carry things in style with a large Tote bag in elegant color.
12. Necklace
Give them a necklace with their initials or with the "To My Nanny" inscribed on them. A cute yet personalized gift that does not feel like you are going overboard. A proud nanny who enjoys her job could very well flaunt it to her friends on an outing with them.
13. Plants
Brighten their home with a nice set of indoor plants that is easy to look after. Several indoor plants are easy to look after and also perfect for serving as décor items.
14. Garden Tools
For those who love gardening, a personalized set of gardening tools will only push them to prune their shrubs or work towards keeping their garden in immaculate condition.
15. Pullover or Jumper
A cozy, knit pullover or jumper will help your nanny stay warm on a cold wintry day. It is also an efficient gift that they will use well. Your nanny could just pull them on when she has to make that trip to drop your kids off at school or dance lessons.
16. Daily Journal Planner
Planning journals come in various shapes, sizes, and contents for those highly organized babysitters. You could even scout online for personalized ones to thank them for their work.
17. Bracelets
If your nanny loves accessories, then bracelets are a great gift. From pretty ones with dainty stones to personalized ones, you have various options to choose from.
18. A Bottle of Wine
Something that will never go out of style, except when your nanny is a tee tootler. Gift them a bottle of pure French wine that has been aged and is a beautiful blend of the best grapes.
19. Petite Purse
A wardrobe essential for everything from vacations, weekend errands to cocktail parties, a classic petite purse could be what they just wished for. Sturdy and timeless, your nanny will love it for the years to come. For a male nanny, you could invest in a pure leather wallet that they can carry everywhere.
20. Bath Bombs
It is no doubt that a nanny or babysitter needs a bit of pampering. A hot bath after a long day will help relax their tired muscles. Organic and natural bath bombs could then become a great gift.
21. Customised T-Shirts
A cute appreciation gift, a customized T-shirt with a funny message, would not seem silly. It will be great for your nanny to slip into after a hard day looking after your children.
22. Box of Chocolates
Who does not like chocolates, and which nanny would refuse a box of sugar that will liven up their spirits? A box of the best chocolate could be an excellent choice for the nanny who slogs and works hard to look after your children.
23. Books
If your nanny or babysitter likes to read, give them the books that are the top reads for the year. A lovely bedtime read to drift into a peaceful sleep is something that your nanny or babysitter will appreciate.
24. Watches
A classic watch with a timeless design is an excellent option for someone who has been with you for years and has looked after all your children. It is an ode to their dedicated effort.
25. Insulated Water Bottle
Always on the go, insulated water bottles will help keep their drinks at the right temperature. With insulated double-walled stainless steel, the bottle is a perfect choice for a gift they will use every day.
A nanny or babysitter undoubtedly is responsible for the peace in your life. If you can go to work without worries about what is going on at home, it is because of your nanny. One cannot measure the amount of effort they take in looking after your baby. It is not easy to fathom the patience that they invest in looking after your child and raising them as their own. One owes a lot of gratitude to such nannies, and it goes without saying that they need to be appreciated. So, show them how much you care by taking pointers from this list and picking a special gift for them.
Also Read:
Benefits of Hiring Live-In-Nanny
Best Babysitting Apps and Websites
What to Put On Your Babysitter Checklist Read more
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Differentiating between Domination and Bullying
There is a very thin line between bullying and dominating behavior and parents often fail to recognize the difference. It is important to read and recognize the signs, so that you are better equipped to help your child.
All children, especially pre-teens, express some degree of dominating behavior. It may be to protect their belongings or to express their resentment against something they do not like.
However, domination turns into bullying when a child’s aggression targets another purely with the intention of upsetting or hurting him. Parents should be observant towards such changing behavior and step in to prevent bullying at as early a stage as possible.
How to Differentiate Between Domination and Bullying
Look for the Intent
The key to differentiate between the two behaviours is that of intention. As a parent, looking for ‘Why’ your child behaved a certain way might give you a clue to whether he is simply dominating or is in the danger of turning into a bully. If the action stems from a desire to hurt or trouble someone, it is bullying behaviour.
Dominating Behavior is Often Reactive
Dominating behavior usually arises from the child’s desire to protect his belongings, from a feeling of being left out from a game. Similarly, this volatile behavior effects young children too. It may just happen from a simple desire to test his boundaries of control. It is often reactive. As a parent, helping a child identify the reason of such behavior can help him overcome it. However, if your child is using domination simply to get his way either with you with other children, it might be the beginning of bullying behavior.
Bullying is Deliberate and Repeated
For a bully, the intention to hurt is very deliberate. A bully often targets the same person again and again by making fun of him, saying mean things or even hitting, kicking or punching him.
Bullying is Against Specific People; Domination is Not
Being dominating is often a part of a child’s personality. He is the same towards all others. A bully however finds a vulnerable target. It may be someone who is physically weak, has fewer friends or is ‘different’ in any way and is not able to respond in equal measure.
Dominant Behavior Might Arise from a Legitimate Position; Bullying Does Not
Some tasks or positions like being a team leader or a class monitor often demand domineering behaviour. This is legitimate. Bullying, on the other hand, goes beyond the demands of the position.
Both bullying and dominating behavior need to be at check. However, bullying has far worse repercussions. Once a child realizes, he can get away with unreasonable behavior, it is difficult to stop him. Other children might take a cue from him and ape his behaviour too. The earlier a parent or caregiver identifies a bully, the easier it is for him to tackle him. Read more
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Dr Priyanka Kalra has added a new answer
Expecting Mom due this month
15 hours ago
Q. i am 39 week of pregnant and having AFI level of 8 is this normal?and is delivery possible for me?
Dr Priyanka Kalra
Obstetrician and Gynaecologist
7 hours ago
A. yes. better to show to specialist always as they get the correct diagnosis. try to avoid self and extra medication that will only complicate this and create more damage to the childdo ultrasound n necessary tests after consulting a specialist. without proper check up we can't advise or help you.. Avoid shirt cuts when it comes to health if mother n baby. ok.
Vandana Sharma has added a new answer
Guardian of 0 children
9 hours ago
Q. please tale me how much dengerous for may 7 days old baby and she was 2.9 kg.
Vandana Sharma
Nutritionist
7 hours ago
A. Hello mom the blood sugar level of baby is quite low , could say hypoglycemia as well .
Dr Ghouse has added a new answer
Guardian of 0 children
7 hours ago
Q. hlw hospital bag main baby nd mom ke liye kiya kiya le jana chahiye???
Dr Ghouse
Paediatrician
7 hours ago
A. hospital bag mein baby ke essentials Deni hogi aap YouTube per dekh sakte hain. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Rashmi has added a new answer
Guardian of 0 children
7 hours ago
Q. my last period was on 29 February 2024 according to which I am 8 weeks 4 days pregnant but my usg scan shows 7 weeks 3 days
Rashmi
Mom of a 9 yr 7 m old girl
6 hours ago
A. For this purpose I’d like to tell you plus -1 or two weeks is completely normal to be seen during ultrasound till the time doctor does not say anything in order of you need to worry about the don’t worry like I said this can be commonly seen in one plus or 2+ weeks or minus weeks is fine
Ashima Malhotra has added a new answer
Expecting Mom due in 5 months
6 hours ago
Q. Am craving to have a burger at McDonald’s. Am 15 week pregnant.
Is it safe to have
Ashima Malhotra
Mom of a 10 m old boy
5 hours ago
A. avoid it
Dr Ghouse has added a new answer
Expecting Mom due in 6 months
5 hours ago
Q. It's my 12th week of pregnancy but last night I noticed some bleeding. So, my doctor prescribed Duphaston for 2 weeks. Is there anything to worry about? Please guide me.
Dr Ghouse
Paediatrician
5 hours ago
A. at present take rest and use medicines as advised by the doctor. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
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