scholarly journals The effect and safety of placental blood drainage as a part of active management of third stage of labour in spontaneous vaginal delivery

Author(s):  
Nidhi Gupta ◽  
Mohita Agarwal ◽  
Saroj Singh ◽  
Parul Gangwar

Background: In placental cord drainage facilitates placental delivery in both vaginal and caesarean section deliveries. The present study was done to evaluate the effect and safety of placental blood drainage as a part of active management of third stage of labour to reduce the duration and blood loss during third stage of labour.Methods: The study was conducted in department of Obstetrics and, SN Medical College, Agra, Uttar Pradesh, India on 400 term pregnant women, with single live intrauterine fetus in cephalic presentation, without any complication. They were randomly divided into to study and control group. Study group: It comprised of 200 Gynaecology cases, underwent active management of third stage of labour with placental blood drainage. Control group: It comprised of 200 cases, underwent active management of third stage of labour (AMTSL) alone. Duration and blood loss during third stage were noted.Results: The mean duration of third stage of labour was 3.61±0.972mins in study group and 8.15±1.711mins in control group. The mean blood loss during third stage of labour was 168.14±76.703ml and 287.40±85.808ml in study and control group respectively.Conclusions: Duration of third stage, blood loss during third stage, and hemoglobin deference between pre and post-delivery were reduced significantly in study group than control group.

Author(s):  
Jaya Kashinathrao Bhongle ◽  
Rashmi Agarwal

Background: PPH is most common cause of maternal mortality accounting for 25-30% incidence and third stage of labour plays most crucial role in preventing postpartum haemorrhage.Methods: A prospective randomized control study in which 100 low risk pregnant women, admitted to labour ward with term gestation were evaluated. They were divided into 2 groups- control group (controlled cord traction) and study group (placental cord blood drainage), 50 pregnant women in each group. Duration of third stage and Amount of blood loss in third stage were evaluated and compared between the 2 groups.Results: Mean duration of third stage of labour in study group was 3.96±1.36 minutes and in control group was 6.00±2.12 minutes. The mean amount of blood loss in third stage of labour in study group was 99.80±56.47 ml in control group was 171.760±96.94 ml. Drop in haemoglobin level after delivery in control group was almost double than study group.Conclusions: Placental cord blood drainage in the management of third stage is non-invasive, easy, safe method which can be used in active management of third stage of labour as it has minimal interference in natural mechanism of placental separation. Placental cord blood drainage should be encouraged for management of third stage of labour universally to all pregnant women specifically in low resource setting areas.


Author(s):  
Charul Mittal ◽  
Jaya Choudhary ◽  
Akshi Agarwal ◽  
Kalpana Tiwari

Background: WHO defines postpartum haemorrhage (PPH) as when blood loss is greater than or equal to 500 ml within 24 hours after birth. When blood loss is greater than or equal to 1000 ml within 24 hourrs, it is called as severe primary postpartum haemorrhage. Placental blood drainage is done by clamping and cutting of umbilical cord after birth of baby followed by unclamping the maternal side of cord so the blood can drain freely into a container.Methods: 200 patients were studied in current research finding. Study group had 100 patients whose placental blood drainage was done and control group had 100 patients whose placental blood drainage was not done. This study was done to analyze the effectiveness of placental blood drainage in reducing blood loss.Results: The duration of third stage of labor was 295.70 seconds in study group and 475.20 seconds in control group. The amount of blood loss in study group was 273.76 ml and 294.92 ml in control group. p value was found to be significant. Incidence of PPH in study group was 1% and 8% in control group.Conclusions: Placenta blood drainage was safe and simple. It is a non invasive method very useful to prevent PPH. It reduces the duration of third stage of labor and reduces amount of blood loss.


Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi

Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section. 


Author(s):  
Sabitha Umapathy Srinivasan ◽  
Swarnamukhi P.

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. The routine practice of active management of third stage of labour has been shown to reduce haemorrhage by up to 60%. The present study evaluated the role of methylergometrine versus oxytocin in active management of third stage of labour in reducing the risk of PPH.Methods: This study was conducted on a total of 400 women admitted in the labour ward of PESIMSR hospital, by using simple randomized design. The first study group included women who received intramuscular oxytocin (n=200) and, the second group included women who received intravenous Methylergometrine (n=200) within, one minute of delivery of the baby.Results: The mean blood loss among study first and the second study group were 172.8 ml and 148.9 ml respectively (p<0.05) and, the mean duration of third stage of labour were 5.9 and 5.1 minutes respectively (p<0.05). The mean pre-and post-delivery haemoglobin values among the first and second group were 11.76 mg/dl, 10.46 mg/dl and, 11.76 mg/dl, 10.6 mg/dl respectively (p<0.05). There was an increase in the blood pressure in the ergometrine group and, slight decrease of blood pressure in oxytocin group.Conclusions: The use of methyl ergometrine as part of active management of third stage of labour was associated with a significant reduction in mean blood loss value, duration of third stage of labour, and the additional need of oxytocic though, methylergometrine has significant side effects like nausea, vomiting and rise in blood pressure.


Author(s):  
Mohammed Abdul Rahman ◽  
Raghunatha Rao D ◽  
Vasantha L

The present study is aimed to study and analyze the true and pseudo Cholinesterase levels in the subjects exposed to pesticides during short term by intentional or accidental intake and long term exposure due to their occupation were studied at Department of Biochemistry, SVS medical college and hospital mahbubnagar district. Whole blood cholinesterase levels and Pseudo cholinesterase levels were estimated. 150 people were taken as controls who had no medical illness and a total number of 300 cases of pesticide poisoning were selected, aged between 20 to 55 years, which consist of 150 acute poisoning and 150 chronic poisoning subjects in Mahbubnagar district, were taken as case study, the detailed case history and the type of organophosphorus pesticide taken were recorded. Mean and standard deviation (S.D) of all variables were calculated and compared with those of controls. Statistical significance was assessed and P-value <0.05 were considered significant.           During acute poisoning the mean value of Whole blood cholinesterase/True cholinesterase (U / L) in acute poisoning cases on first day was 1.267± 0.612 on 3th day was 1.651±0.647, on 7th day was 2.221±0.684 and at the end of 6 months was 3.970±0.404.The difference between the study group and control group (4.0 ± 0.39) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in acute poisoning cases on first day was 2213.05 ± 1749.81, on 3th day was 2862.3 ± 2025.6, on 7th day was 4008.4 ± 2355.9 and at the end of 6 months was 7708.34 ± 880.72.The difference between the study group and control group (7991.97 ± 1276.5) was found to be statistically significant in1st, 3rd, 7th day but not significant at the end of 6 months. During chronic poisoning (exposure) the mean value of Whole blood cholinesterase (U/L) in controls is 4.0 ± 0.39 as compared to 3.019 ± 0.848 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant. The mean value of serum cholinesterase/pseudo cholinesterase (U/L) in controls was 7991.97 ± 1276.5 as compared to 6214 ± 1189 in cases of chronic poisoning. The difference between the study group and control group was found to be statistically significant.


Author(s):  
Rahul Kirtania ◽  
Jayita Pal ◽  
Sisir Biswas ◽  
Aditi Aich

Background: PPH is the prime cause of maternal mortality worldwide. The incidence of PPH can be drastically combatted by application of uterotonic in active management of third stage labour. Timing of its administration is a matter of concern. This study aimed to assess whether timing of administration of oxytocin would have any impact on incidence or mean blood loss of PPH.Methods: It was a single blinded randomized controlled trial conducted in the department of Obstetrics and Gynecology, Bankura Sammilani Medical College for 6 months where 100 antenatal mothers admitted for normal delivery in labour room were allocated randomly in study and control group considering inclusion and exclusion criteria. Incidence of PPH and mean blood loss had been identified clinically by following them for 24 hours.Results: Only 9% of study population had experienced PPH. There was no statistically significant difference in incidence of PPH with difference in timing of administration of oxytocin (p >0.05). But there was statistically significant decrease in mean blood loss if oxytocin was administered before the placental delivery. The mean blood loss with oxytocin administered before placental delivery was 296.8 ml (102.45) and after placental delivery was 452.0 (128.87) ml respectively.Conclusions: Policy makers should keep in mind not only the incidence of PPH, but the mean blood loss amount too in a setting where anaemia in pregnancy is quite prevalent.


Author(s):  
Neelam Jhajharia ◽  
Madhureema Verma

Background: Pregnancy induced hypertension (PIH) is one of the most common and potential life-threatening complications of pregnancy. This study is aimed to investigate and correlate the hemoglobin, haematocrit, white blood cell count, lymphocytes and platelets in PIH patients in their third trimester.Method: Total 126 subjects were studied out of them 63 patients (case) and 63 healthy pregnant women (control) visiting the Obstetrics and Gynaecology department Jhalawar Medical College, Jhalawar were registered in the study and followed during their pregnancy. Two millilitre of blood sample was drawn aseptically using the 5ml syringe from the median ante cubital vein of all the cases and control participants into EDTA-anticoagulated tubes. Haematological parameter calculated by using Sysmex XN-9100™ Automated Haematology System.Results: The mean hemoglobin level of the case group (8.8206±2.53779) was significantly lower than that of the control group (9.7289±2.47033) (p<0.05). The mean platelet count of the case group (131.4937±62.05999) was significantly lower than that of the control group (324.9683±230.78764) (p<0.05). The mean lymphocytes level of case group (1.2510±0.56369) was significantly lower than that of the control group (1.9295±1.4150) (p<0.05). The mean WBC level of case group (36.3467±119.90635) was significantly high than control group (11.5260±4.83059) (p<0.05). The mean haematocrit level of case group (32.6851±7.29789) was significantly high than control group (30.0424±23.38116) (p<0.05).Conclusion: The mean hemoglobin, mean platelets and mean lymphocytes are lower in PIH patients. The mean WBC and haematocrit are higher in PIH patient. 


QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p &lt; 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p &lt; 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p &lt; 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p &lt; 0.001), Reduction in Hematocrite was significantly less in study group than control group (p &lt; 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.


2010 ◽  
Vol 17 (6) ◽  
pp. E17-E20 ◽  
Author(s):  
Ercan Varol ◽  
Akif Arslan ◽  
Habil Yucel ◽  
Mehmet Ozaydin ◽  
Dogan Erdogan ◽  
...  

Background: Systemic thromboembolism is a serious complication in patients with aortic stenosis (AS). Previous studies have demonstrated that platelet activation occurs in patients with AS. The aim of this study was to assess the mean platelet volume (MPV), an indicator of platelet activation in patients with AS. Patients and Methods: The study group consisted of 43 patients with AS. An age-, gender-, and body mass index−matched control group consisted of 35 healthy volunteers. All patients and control participants underwent echocardiographic examination. We measured the serum MPV values in patients and control participants. Results: Mean platelet volume was significantly higher among patients with AS when compared with the control group (8.7 ± 1.0 vs 7.9 ± 0.9 fL, respectively; P = .001). Conclusion: We have shown that MPV was significantly elevated in patients with AS compared to control participant.


2015 ◽  
Vol 59 (3) ◽  
pp. 258-264 ◽  
Author(s):  
Zehra Safi Oz ◽  
Banu Doğan Gun ◽  
Mustafa Ozkan Gun ◽  
Sukru Oguz Ozdamar

Objectives: The aim of this study was to explore the cytomorphometric and morphological effects of Trichomonas vaginalis in exfoliated epithelial cells. Study Design: Ninety-six Pap-stained cervical smears were divided into a study group and two control groups as follows: T. vaginalis cases, a first control group with inflammation, and a second control group without inflammation. Micronucleated, binucleated, karyorrhectic, karyolytic, and karyopyknotic cells and cells with perinuclear halos per 1,000 epithelial cells were counted. Nuclear and cellular areas were evaluated in 70 clearly defined cells in each smear using image analysis. Results: The frequencies of morphological parameters in the T. vaginalis cases were higher than the values of the two control groups, and the difference among groups was found to be significant (p < 0.05). The nuclear and cytoplasmic areas of epithelial cells were diminished in patients with trichomoniasis. The mean nucleus/cytoplasm ratio in T. vaginalis patients was higher than the value in the control groups, and the difference between the study group and control group 1 was significant. However, there was no statistically significant increase between the study group and control group 2. Conclusions:T. vaginalis exhibited significant changes in the cellular size and nuclear structure of the cells. The rising frequency of micronuclei, nuclear abnormalities, and changing nucleus/cytoplasm ratio may reflect genotoxic damage in trichomoniasis.


Sign in / Sign up

Export Citation Format

Share Document