{
  "abstract": "Background and Aims Uterine atony (UA) is a medical condition where the uterus fails to contract effectively either after labor or cesarean section (CS). This can lead to postpartum hemorrhage (PPH), which can be life threatening. The present study describes a case of UA during CS that received spinal anesthesia (SA), that lead to acute hysterectomy. Most of the similar cases reported, converted the anesthesia from spinal to general (GA).Methods A 28 year old female underwent a selective CS due to previous CS. The patient‘s medical history was clear, and her pregnancy was uneventful. The patient was informed and consented to spinal anesthesia. A 25G pencil point spinal needle was used and the patient received a mixture of Ropivacaine 7.5% and Fentanyl. The operation until the baby’s delivery was uneventful and the patient was stable. After the removal of the placenta, the patient presented a massive bleeding with subsequent hypotension and tachycardia. Uterine massage and uterine contraction medication did not produce any results, thus the gynecologists decided to proceed with an emergency hysterectomy. The patient was treated aggressively with liquids and vasopressors. Due to hemodynamic instability of the patient, it was decided to not convert to GA as the patient was fully alert and responsive and to avoid any futher hemodynamic fluctuations.Results Despite her condition the patient did not manifest other symptoms apart from mild nausea and exhaustion feeling. She was calm and informed about the situation. SA did not cause any further hemodynamic instability. As soon as the uterus was removed, the bleeding ceased, vasopressors were no longer needed and the rest of the operation was uneventful.Conclusions While GA remains the most common choice for emergency hysterectomy, SA can be maintained in certain cases, especially if the patient is stable, and has no contraindications. However, it requires continuous careful assessment and management.",
  "authors": [
    {
      "affiliations": [
        "Anesthesia and Pain Unit, General Hospital of Rhodes, Greece, Rhodes, Greece"
      ],
      "name": "Theofilos Tsoleridis"
    },
    {
      "affiliations": [
        "Anesthesia and Pain Unit, General Hospital of Rhodes, Greece, Rhodes, Greece"
      ],
      "name": "Maria Diakostavrianou"
    },
    {
      "affiliations": [
        "Anesthesia and Pain Unit, General Hospital of Rhodes, Greece, Rhodes, Greece"
      ],
      "name": "Dimitra Laspa"
    }
  ],
  "title": "P098 Acute hysterectomy due to uterine atony under spinal anesthesia: a case report",
  "uid": "412b7d39-0109-5d37-877a-65806dfc54ac"
}