Are cord traction or uterine massage in the third stage of labor effective in decreasing postpartum hemorrhage?

Background: One of the causes of postpartum hemorrhage is prolongation of third stage of labor. Mother-infant skin to skin contact (SSC) immediately after delivery is one of the non-pharmacological interventions to reduce this stage. Studies which assessed the effect of mother-infant SSC after delivery on duration of the third stage of labor reported controversial results on this issue. Therefore, this study investigated the effect of mother-infant SSC immediately after birth on the duration of third stage of labor Methods: In this systematic review and meta-analysis, the databases of PubMed, Scopus, Cochrane, SID, Magiran IranDoc and Google Scholar were searched from 2000 to 2018, using the keywords related to the objectives of this review to access randomized control trials published in Persian or English. The quality of papers was examined using Cochran's Risk of bias tool. Data was analyzed using Stata software. We used I2 index and Chi-square test to investigate heterogeneity and Egger’s and Begg’s tests to assess publications bias. Random effects model was used to combine the data. Results: Six studies were entered into the meta-analysis. The third stage of labor in SSC group was shorter than that of control group with a mean difference of -1.33 and 95% CI (-2.31 to -0.36) and this difference was statistically significant (P=0.007). Conclusion: Mother-infant SSC decreases the duration of third stage of labor. Therefore, the current study provides some evidences to use this non-pharmacological method in order to accelerate the third stage of labor and ultimately prevent postpartum hemorrhage.

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Prevenção e tratamento da hemorragia pós-parto

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v13i1a238415p236-248-2019 ◽

2019 ◽

Vol 13 (1) ◽

pp. 236

Author(s):

Rita de Cássia de Oliveira ◽

Rejane Marie Barbosa Davim

Keyword(s):

Thematic Analysis ◽

Postpartum Haemorrhage ◽

Virtual Library ◽

The Third ◽

Third Stage Of Labor ◽

Puerperal Infection ◽

Third Stage ◽

Uterine Massage ◽

Controlled Cord Traction ◽

Mortalidade Materna

ABSTRACTObjective: to identify the evidence on the prevention and treatment of postpartum haemorrhage in health care. Method: this is a descriptive and quantitative bibliographical study of the type integrative, with temporal delimitation from 2007 to 2017, with a search in the databases LILACS, MEDLINE and SciELO Virtual Library, and the results are presented in figure, analyzed by the technique of Content Analysis in the Thematic Analysis modality. Results: totaling 100 articles, which, after refinement, totaled 11 eligible for discussion with the literature. Conclusion: the correct management of the third stage of labor with the prophylaxis of postpartum haemorrhage was fundamental, based on the use of uterotonic drugs, controlled cord traction and uterine massage in place of clamping of the cord. Descriptors: Pregnant women; Pregnancy; Bleeding; Maternal Mortality; Puerperal infection; Women's Health.RESUMOObjetivo: identificar as evidências sobre a prevenção e o tratamento da hemorragia pós-parto em cuidados no campo da saúde. Método: trata-se de um estudo bibliográfico, descritivo e quantitativo, do tipo revisão integrativa, com delimitação temporal de 2007 a 2017, com busca nas bases de dados LILACS, MEDLINE e Biblioteca Virtual SciELO, e os resultados se apresentam em figura, analisados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: totalizaram-se 100 artigos que, após refinamento, totalizaram 11 elegíveis para discussão com a literatura. Conclusão: evidenciou-se que é fundamental o manejo correto no terceiro estágio do trabalho de parto, com a profilaxia da hemorragia pós-parto, tendo como base o uso de drogas uterotônicas, a tração controlada de cordão e a massagem uterina em substituição ao clampeamento do cordão. Descritores: Gestantes; Gravidez; Hemorragia; Mortalidade Materna; Infecção Puerperal; Saúde da Mulher.RESUMENObjetivo: identificar las evidencias sobre la prevención y el tratamiento de la hemorragia posparto en cuidados en el campo de la salud. Método: se trata de un estudio bibliográfico, descriptivo y cuantitativo, del tipo revisión integrativa, con delimitación temporal de 2007 a 2017, con búsqueda en las bases de datos LILACS, MEDLINE y Biblioteca Virtual SciELO, y los resultados se presentan en figura, analizados por la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se totalizaron 100 artículos que, después de refinamiento, totalizaron 11 elegibles para discusión con la literatura. Conclusión: se evidenció que es fundamental el manejo correcto en la tercera etapa del trabajo de parto, con la profilaxis de la hemorragia posparto, teniendo como base el uso de drogas uterotónicas, la tracción controlada de cordón y el masaje uterino en sustitución al clampeamiento del cordón. Descriptores: Mujeres Embarazzadas; Embarazzo; Hemorrragia; Infección Puerperal; Salud de la Mujer.

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Assessment of Midwife Knowledge, Practice, and Associated Factors towards Active Management of the Third Stage of Labor at Governmental Health Institutions in Tigray Region, Northern Ethiopia, 2018

BioMed Research International ◽

10.1155/2020/8547040 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Getu Engida Wake ◽

Girma Wogie

Keyword(s):

Postpartum Hemorrhage ◽

Active Management ◽

Knowledge Level ◽

Practice Level ◽

Tigray Region ◽

The Third ◽

Third Stage Of Labor ◽

Third Stage ◽

Knowledge Practice ◽

Health Institutions

Introduction. Globally, postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths. The majority of death due to postpartum hemorrhage is caused by uterine atony. Routine and correct usage of active management of the third stage of labor decreases the occurrence of postpartum hemorrhage by 60% when compared to expectant management of the third stage of labor. The purpose of this study was to assess midwife knowledge, practice, and associated factors towards active management of the third stage of labor at governmental health institutions in the Tigray region, 2018. Results. These study results showed that from the total study participants ( N = 278 ), 170 (61.2%) were good in knowledge and 121 (43.5%) were good in practice towards active management of the third stage of labor. Training related to active management of the third stage of labor ( AOR = 2.119 , 95 % CI = 1.141 , 3.3937) and practice level of midwives ( AOR = 8.089 , 95 % CI = 4.103 , 15.950) became significantly associated with the knowledge level. The educational level of midwives ( AOR = 3.811 , 95 % CI = 2.015 , 7.210), training related to active management of the third stage of labor ( AOR = 2.591 , 95 % CI = 1.424 , 4.714), and knowledge level of midwives towards active management of the third stage of labor ( AOR = 7.324 , 95 % CI = 3.739 , 14.393) were significantly associated with the practice level. This study showed that training related to active management of the third stage of labor was significantly associated with the knowledge and practice level of midwives. The educational level and knowledge level of midwives were significantly associated with the practice level of midwives towards active management of the third stage of labor. Therefore, midwives should update their academic level and knowledge. Health institutions in collaboration with the Tigray Regional Health Bureau should arrange training for all midwives to bring change.

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