scholarly journals Study of effect of intra-umbilical oxytocin along with active management in third stage of labor

2021 ◽  
Vol 10 (9) ◽  
pp. 3486
Author(s):  
Neetu Verma ◽  
Monica Soni ◽  
Priyanka Singh
Keyword(s):  
Blood Loss ◽  
Normal Saline ◽  
Demographic Data ◽  
Active Management ◽  
P Value ◽  
Study Group ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: The aim of the study was to determine effect of intra-umbilical oxytocin along with active management on duration and amount of blood loss in 3rd of stage of labor.Methods: This was a hospital based prospective, randomized, case-control study conducted in the department of OBG between 1st September 2019 to 31st December 2020. After obtaining permission from ethical committee, screening of inclusion and exclusion criteria and informed consent of participants, 300 cases were enrolled. In group A (control) 20 ml normal saline and in group B (case) 20 IU oxytocin diluted in normal saline to make a 20 ml solution was given intra-umbilically along with standard active management of third stage labor. The data was systematically recorded and analysed.Results: Both the groups were comparable in terms of demographic data.  A statistically significant reduction in the duration of third stage of  labor (1.83±0.64  min in group B vs 2.92±0.79 min in group A), amount of blood loss (203.73±62.11 ml in group B vs 328.83±87.18 ml  group A) and fall in haemoglobin (9.28±1.03 g/dl in the study group A vs 9.97±1.28 g/dl in group B) and haematocrit (31.20±3.05% in  study group A vs 33.60±3.31%  in study group B)  were noted, taking p value  significant <0.05.Conclusions: Intra-umbilical oxytocin was associated with a significant reduction in duration and amount blood loss in third stage of labor.

scholarly journals Third stage of labour: expectant versus active management-a comparative study in local low risk population

2019 ◽  
Vol 8 (2) ◽  
pp. 641
Author(s):  
Kavita A. Chandnani ◽  
Deepti D. Sharma
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Maternal Mortality ◽  
Post Partum ◽  
Expectant Management ◽  
Active Management ◽  
Research Centre ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. These deaths have a major impact on the lives and health of the families affected. Thus, anticipation as well as proper management of 3rd stage of labour is mandatory. The objective of this study was to compare expectant and active management of third stage of labour in preventing post-partum blood loss and having impact on prevention of maternal mortality in local population. Advantages and disadvantages of both techniques might be over estimated.Methods: Prospective comparative study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 200 laboring women admitted directly or from OPD to labour room for expected vaginal delivery. They were randomly allocated to group A (expectant management) and group B (active management). Labour progress was charted on partograph and interventions recorded. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for descriptive variables were calculated and appropriate statistical tests applied to determine significance.Results: Average PPBL (post-partum blood loss) was 360.5ml in group A as compared to 290.6ml in group B. 12 patients in group A had blood loss more than 500ml while none in group B. 66% cases in group B had duration of third stage of labour less than 5 min as compared to only 22% in group A. the mean duration of third stage was 13.46±8.3 in group A while 5.32±3.05 in group B. these differences were statistically significant.Conclusions: Active management of the third stage of labour is associated with less blood loss as well as a shorter duration of third stage compared with expectant management. It is reasonable to advocate this regime.

scholarly journals A Comparative Study of Active Management of the Third Stage of Labor IV Methergine and IM Oxytocin

2021 ◽  
pp. 267-272
Author(s):  
K. Sharmila
Keyword(s):  
Blood Loss ◽  
The United States ◽  
Active Management ◽  
P Value ◽  
Negative Effects ◽  
The Third ◽  
Third Stage Of Labor ◽  
Group I ◽  
Third Stage ◽  
The Mean

Postpartum haemorrhage (PPH) has been more common over the last three decades, accounting for 11% of all pregnancy-related deaths in the United States. In the third stage of labour, risk classification and active management are crucial preventative techniques. To avoid negative effects, a multidisciplinary approach to PPH patient care is required. To treat uterine atony, uterotonic medicines like oxytocin are used in combination with manipulative procedures like uterine massage and balloon tamponade. The amount of blood loss, duration of the third stage, need for MRP, incidence of PPH, need for repeated oxytocics, and its side effects were measured in Group I 100 women who were administered injection oxytocin 10 IU injection methergin 0.2 mg IV within one minute of the baby's delivery. The mean blood loss at vaginal delivery in Group I was 100-150 ml and in group I P value 0.027, which was statistically significant .In  Group II was 160-200 ml with P value 0.036, which was statistically significant. The mean duration of third stag labour in Group 1 was 124.6 min and Group 2 was 144.8 min intravenous methergin is a better uterotonic when compared to intramuscular oxytocin to reduce the amount of blood loss at delivery and prevent complications like atonic PPH.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

scholarly journals A comparative study of the effectiveness of placental blood drainage versus no placental blood drainage in active management of third stage of labor at a tertiary care hospital

2020 ◽  
Vol 9 (11) ◽  
pp. 4636
Author(s):  
Charul Mittal ◽  
Jaya Choudhary ◽  
Akshi Agarwal ◽  
Kalpana Tiwari
Keyword(s):  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Care Hospital ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Placental Blood

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.

scholarly journals Use of Oral Misoprostol, Intramuscular Oxytocin and Intravenous Methergin in Prevention of Postpartum Haemorrhage

2013 ◽  
Vol 8 (1) ◽  
pp. 34-36
Author(s):  
Banwari Lal Meena
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Active Management ◽  
P Value ◽  
Multi Centre Study ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Group B ◽  
A Prospective Study

Aims: The purpose of the study was to compare the efficacy of misoporstol 600mg orally (Group A), injection oxytocin 10 IU intramuscularly (Group B) and injection methylergometrine 0.2 mg intravenously (Group C) on reducing blood loss in third stage of labour, duration of third stage of labour, effect on haemoglobin of the patient, need of additional oxytocics or blood transfusion and associated side effects and complications. Methods: A prospective study enrolling 510 women and randomising them into three groups was done in S P Medical College, Bikaner, Rajasthan, India. Active management of third stage of labour was done using one of the three uterotonics as per the group of the patient. Results: Methylergometrine was superior to rest of the drugs with lowest duration of third stage of labour (p = 0.02), lowest amount of blood loss (p = 0.0001) and lowest rate of post partum hemorrhage (p = 0.08). The need of additional oxytocics and blood transfusion was highest with oral misoprostol as compared to all other drugs used in the study with p value of 0.08 and 0.009 respectively. Conclusions: Methylergometrine has the best uterotonic drug profile amongst the drugs used, strongly favouring its routine use as oxytocic for active management of third stage of labour. Oral misoprostol resulted in a higher blood loss compared to other drugs and hence it should be used only in low-resource settings where other drugs are not available. However, a large multi-centre study is needed for the confirmation of the finding. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 34-36 DOI: http://dx.doi.org/10.3126/njog.v8i1.8859

scholarly journals POSTPARTUM HAEMORRHAGE

2015 ◽  
Vol 22 (06) ◽  
pp. 793-797
Author(s):  
Faiqa Saleem Baig ◽  
Nadeem Shahzad ◽  
Hafiza Naveeda Khurshid ◽  
Aisha Malik
Keyword(s):  
Blood Loss ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Significant Risk ◽  
Developed Countries ◽  
Active Management ◽  
Preventive Strategy ◽  
Third Stage ◽  
Group A ◽  
Group B

The most common complication 0f the third stage of labour is postpartumhaemorrhage, which remains a leading cause of maternal mortality (25.0%), especially indeveloping countries. In developed countries, 3-5% of deliveries are complicated by postpartumhaemorrhage: in developing countries, it is 50 times more common .Third stage of labourwhich exceeds 30 minutes is associated with a significant risk of postpartum haemorrhage andpuerperal infection. The best preventive strategy for these complications is active managementof third stage of labour. Active management includes administration of oxytocin within oneminute of birth of baby. Objectives: To compare the mean blood loss after administration ofintra umbilical oxytocin versus intravenous oxytocin at anterior shoulder for active managementof third stage of labour. Study Design: Randomized controlled trial. Period: Six months from1-1-2013 to 30-06-2013. Setting: Department of Obstetrics and Gynaecology, Unit-III JinnahHospital Lahore. Methodology: 100 patients fulfilling selection criteria were included in thestudy from labour room. These patients were randomly divided into two groups by usinglottery method. Group-A, 50 patients were administered 10 units of oxytocin diluted in 20ml ofnormal saline intraumbilically and group-B, 50 patients were administered 5 units of oxytocinintravenous stat at anterior shoulder. Total blood loss was noted after complete delivery ofplacenta. Results: Mean age was 25.0±3.9 and 24.4±3.5 in group-A and B, respectively. Meangestational age was 38.20±0.96 weeks in group-A and 38.40±0.94 weeks in group-B. Meanblood loss in intraumbilical oxytocin group was 311.20±27.23 ml and in intravenous oxytocingroup mean blood loss was 373.60±66.47 ml. There was statistically significant differencebetween two groups (p<0.001). In group-A 15 patients (30.0%) and in group-B 20 patients(40.0%) were primigravida while remaining patients were multigravida. Conclusion: The usageof intraumbilical oxytocin in active management of third stage of labour is beneficial in reducingthe blood loss in third stage and thus helps in preventing postpartum haemorrhage.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals ELECTIVE MIDLINE LAPAROTOMY

2011 ◽  
Vol 18 (01) ◽  
pp. 106-111
Author(s):  
ARSALAN SIRAJ ◽  
ATHAR ABBAS SHAH GILANI ◽  
MUHAMMAD FAROOQ DAR ◽  
Sohail Raziq
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Wound Infection ◽  
Visual Analogue Score ◽  
P Value ◽  
Midline Laparotomy ◽  
Pain Scores ◽  
Group A ◽  
Insignificant Difference ◽  
Group B

Objectives: To compare the diathermy incision with scalpel incision in patients undergoing midline elective laparotomy. Design of Study: A prospective, experimental comparative study. Place and Duration: Department of surgery, PNS Shifa Karachi, from March 2007 to June 2008. Patients and Methods: A total of 100 patients were included in the study, and equally divided into 2 groups. Group A received scalpel incision while in group B diathermy was employed to incise all layers. Peroperative parameters including, incision time and blood loss were calculated. Postoperatively, pain was assessed by visual analogue score and wound infection documented. Results: Both groups included fifty patients each out of the total 44 females and 56 were males, with similar gender preposition in both the groups. Mean age of patients in scalpel group was 48.78 (±14.47) while it was 44.92 (±15.87) in diathermy group. The mean incision related blood loss in Scalpel group was 1.53 (±0.20) ml/cm2 and in Diathermy group was 1.43 (±0.20) ml/cm2, showing significantly less bleeding in diathermy group (p-value= 0.014). Diathermy group, with incision related time of 6.20 sec/cm2 (±0.97 sec/cm2), was significantly quicker (p-value= 0.003) than scalpel incision, with incision time of 6.76 sec/cm2 (±0.84 sec/cm2). Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups. Conclusions: Diathermy, employed for midline laparotomy, is quicker and hemostatic, compared to the scalpel. The two are, however, similar in terms of wound infection and postoperative pain.

SUBLINGUAL MISOPROSTOL FOR PREVENTION OF POSTPARTUM HAEMORRHAGE – A RANDOMISED CONTROL TRIAL

2021 ◽  
pp. 56-57
Author(s):  
Anupama Anupama
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Outcome Measures ◽  
Post Partum ◽  
Randomised Control Trial ◽  
Study Group ◽  
Sublingual Misoprostol ◽  
Group A ◽  
Post Partum Haemorrhage ◽  
Group B

Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH. Materials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40 years with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum haemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group A (n=50) and placebo group or group B(n=50). Group A received 400µg of sublingual misoprostol after delivery of the baby, group B received placebo tablet at the same time. Primary outcome measures were blood loss from delivery of the placenta to the end of the caesarean section to 2 hours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration was noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum haemorrhage. Result – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were signicantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signicantly less than in the control group. (p<0.0001). Total amount of Oxytocin required was signicantly less in the study group (p=0.01). The number of women requiring other oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signicantly less in study group (p=0.0078). Conclusion – Sublingual misoprostol has been found to be effective in preventing PPH.

scholarly journals Active management of third stage of labor

1970 ◽  
Vol 1 (2) ◽  
pp. 25-27
Author(s):  
Meena Thapa ◽  
Rachana Saha ◽  
Sumita Pradhan ◽  
Sushil Thakur ◽  
Archan Shamsher Rana
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
College Teaching ◽  
Uterine Atony ◽  
Active Management ◽  
Retained Placenta ◽  
Average Blood Loss ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage

Objective: Overall objective of the study was to see effects of active management of third stage of labour (AMSTL) with oxytocin. Specific objective of the study was to look for incidence of Post-Partum Haemorrhage (PPH), length of 3rd stage, incidence of retained placenta and average blood loss. Methodology: A hospital based prospective, descriptive, observational study was carried out from 1st July 2005 to 30th June 2006 at department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital (KMCTH). All patients undergoing vaginal delivery excluding twins, polyhydraminios and instrumental deliveries were included in the study. The active management of 3rd stage included administration of 10 units IU of oxytocin, early cord clamping, controlled cord traction and uterine massage. Blood loss was estimated by visual inspection and measured by jar pressed against perineum. Result: Total number of deliveries during the study period was 530. There were 13 cases of PPH. Incidence of PPH was 2.4%. There were six cases each of uterine atony and genital tract trauma. One case was of retained placenta requiring Manual Removal (MRP). Average third stage duration was less than 5 minutes. Average blood loss was 90 ml. In 2 cases the third stage lasted more than 30 mins. Conclusion: Active management of 3rd stage of labour reduces the incidence of PPH from uterine atony, reduces the duration as well as average blood loss during third stage.condition. Key words: Labor analgesia; epidural, combined spinal epidural; complications, dural puncture, postdural puncture headache (PDPH); prevention.   doi:10.3126/njog.v1i2.1490 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 25 - 27 Nov-Dec 2006

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