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This case report examines uterine atony in a systemic lupus erythematosus patient and its microscopic features. A 37-year-old woman with systemic lupus erythematosus, in her fourth pregnancy, experienced vaginal bleeding, and severe hypotension after delivering at 32\u201333 weeks. Despite treatments including fluids, oxytocin, misoprostol, and methylergometrine, uterine contractions did not improve, leading to a supravaginal hysterectomy. Histopathology revealed hypertrophic myocytes and extensive fibrosis. This case suggests that systemic lupus erythematosus may increase the risk of uterine atony and postpartum hemorrhage due to uterine fibrosis and reduced response to uterotonics.<\/jats:p>","DOI":"10.1177\/2050313x251344026","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T09:41:32Z","timestamp":1750066892000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Postpartum uterine atony complicating labor in a patient with systemic lupus erythematosus: A case report"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2176-7722","authenticated-orcid":false,"given":"Amadea Ivana","family":"Hartanto","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amillia","family":"Siddiq","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferdy","family":"Ferdian","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruswana","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanom Husni","family":"Syam","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Birgitta Maria","family":"Dewayani","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology, Dr. Hasan Sadikin General Teaching Hospital, Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1583736"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1759633"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203315603141"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/cei.12587"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2022.102864"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.09.001"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14116"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.25077\/jka.v8i2S.958"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001962"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-019-01212-8"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04864-z"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1080\/01443615.2017.1340439"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12118"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.31083\/j.ceog.2020.05.5367"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000397"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182998fb6"},{"key":"e_1_3_2_18_2","volume-title":"Uterine atony","author":"Gill P","year":"2025","unstructured":"Gill P, Patel A, Van Hook JW. 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