Behandling af svaer post partum atoni med prostaglandin

Postpartum atony with haemorrhage is a life-threatening condition which may necessitate surgical intervention with ligation of the ascending arterial branches or hysterectomy. On the basis of the literature, recent medical treatment with the prostaglandins F2 alpha and E2 is reviewed. When this treatment was employed, surgical intervention could be avoided in 60-100% of the cases which did not respond to ordinary treatment for atony. The forms of administration, which may be intravenous, intramuscular, intravaginal or injection into the myometrium, are discussed. In addition, the dosage, choice of prostaglandin and the contraindications of treatment are reviewed. It is concluded that prostaglandin treatment should be considered prior to surgical treatment and that the possibilities of obtaining prostaglandin rapidly should be present in all maternity departments.