Comparative evaluation of methods of bleeding prevention in the afterbirth and early postnatal periods (literature review)

According to the WHO, each year about 140,000 women die of postpartum hemorrhage, which occur in 5-15% of births. The most common cause of postpartum hemorrhage remains hypotension uterus. Many methods of prevention of obstetric hemorrhage developed, but not all of them have high efficiency. Massive bleeding, life-threatening women, are observed very often. At the present time, the question of active or waiting tactics of the third stage of labour remains controversial. Active tactics of the third stage of labour is recognized as the main method of prevention of postpartum hemorrhage, and includes the use of oxytocin - drug first-line and second-line drugs – ergometrine and prostaglandins. Also the traction of the umbilical cord with extra pressure on the uterus to the placenta (controlled traction of the umbilical cord) is carried out. In contrast of active tactics, waiting tactics involve independent birth of the placenta. Active tactic of third stage of labour compared with expectant tactics leads to reduced blood loss, but its use increases the risk of side effects. Clear organization for the prevention of postpartum hemorrhage is the real basis of the reduction of maternal mortality and remote serious consequences for the mother.