scholarly journals A study of placental blood drainage in third stage of labour to prevent postpartum haemorrhage: a randomized controlled study

2021 ◽  
Vol 10 (11) ◽  
pp. 4226
Author(s):  
Jaya Kashinathrao Bhongle ◽  
Rashmi Agarwal
Keyword(s):  
Blood Loss ◽  
Cord Blood ◽  
Pregnant Women ◽  
Active Management ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Resource Setting ◽  
Third Stage ◽  
Placental Blood

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.

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

2019 ◽  
Vol 8 (5) ◽  
pp. 1977
Author(s):  
Nidhi Gupta ◽  
Mohita Agarwal ◽  
Saroj Singh ◽  
Parul Gangwar
Keyword(s):  
Blood Loss ◽  
Uttar Pradesh ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Medical College ◽  
Third Stage ◽  
Placental Blood ◽  
The Mean ◽  
And Control

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.

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 Study of the efficacy of tranexamic acid in reducing blood loss after child birth

2021 ◽  
Vol 10 (5) ◽  
pp. 1863
Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Third Stage

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. 

scholarly journals The influence of gestational hypertension on cord blood adiponectin levels: a case-controlled study

2021 ◽  
Vol 12 ◽  
pp. 204201882110585
Author(s):  
Justyna Czubilińska-Łada ◽  
Aleksandra Gliwińska ◽  
Elżbieta Świȩtochowska ◽  
Lucyna Nowak-Borzȩcka ◽  
Beata Sadownik ◽  
...  
Keyword(s):  
Cord Blood ◽  
Metabolic Disorders ◽  
Gestational Hypertension ◽  
Adiponectin Level ◽  
Anthropometric Measurements ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Anthropometric Parameters ◽  
Significant Difference

Introduction: Gestational hypertension is one of the most common complications of pregnancy and childbirth worldwide and may be associated with metabolic disorders. Adiponectin is an adipocyte-specific plasma protein with insulin-sensitizing, vascular-protective, anti-inflammatory properties, and its role in metabolic disorders in prenatal and postnatal development in neonates remains unclear. The primary purpose of this study was to determine whether gestational hypertension is a condition lowering cord blood adiponectin level. Next, we have evaluated whether cord blood adiponectin level correlates with selected anthropometric parameters in neonates. Material and methods: The case–control study included 89 newborns divided into two groups: 30 neonates in the study group whose mothers were diagnosed with gestational hypertension and 59 healthy neonates born from normotensive pregnancies. Adiponectin determinations were performed in both groups, and neonatal anthropometric measurements and perinatal data were collected. Results: There was no statistically significant difference ( p = 0.27) between adiponectin concentration in cord blood of newborns from the study group [median (Q1–Q3) 9.86 μg/ml (8.16–13.26 μg/ml)] compared with the control group [median (Q1–Q3) 10.65 μg/ml (8.69–14.29 μg/ml)]. No statistically significant correlations were observed between adiponectin level and gestational age, body weight, body length, and chest circumference. A significant correlation was observed between adiponectin level and head circumference among newborns in the control group and among the entire population of newborns included in the study. Conclusion: No significant influence of gestational hypertension on cord blood adiponectin levels or their correlation with neonatal anthropometric measurements was observed.

Acupuncture for Insomnia in Pregnancy – a Prospective, Quasi-Randomised, Controlled Study

2005 ◽  
Vol 23 (2) ◽  
pp. 47-51 ◽  
Author(s):  
João Bosco Guerreiro da Silva ◽  
Mary Uchiyama Nakamura ◽  
José Antonio Cordeiro ◽  
Luiz Kulay
Keyword(s):  
Pregnant Women ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Real Life ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Randomised Controlled Study ◽  
Numerical Rating ◽  
Randomised Controlled

Objective This study was undertaken to test the effects of acupuncture on insomnia in a group of pregnant women under real life conditions, and to compare the results with a group of patients undergoing conventional treatment alone (sleep hygiene). Methods A total of 30 conventionally treated pregnant women were allocated at random into groups with or without acupuncture. Seventeen patients formed the study group and 13 the control group. The pregnant women scored the severity of insomnia using a Numerical Rating Scale from 0 to 10. Women were followed up for eight weeks and interviewed five times, at two-week intervals. Results Eight women dropped out, five in the study group and three in the control group. The study group reported a larger reduction on insomnia rating (5.1) than the control group (0.0), a difference which was statistically significant (P=0.0028). Average insomnia scores decreased by at least 50% over time in nine (75%) patients in the study group and in three (30%) of the control group. Conclusion The results of this study suggest that acupuncture alleviates insomnia during pregnancy and further research is justified.

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 Placental cord blood drainage after vaginal delivery as part of the management of third stage of labour: a systematic review of randomized controlled clinical trial

2017 ◽  
Vol 6 (9) ◽  
pp. 4001 ◽  
Author(s):  
S. A. Meena ◽  
D. S. Bebincy ◽  
Devika .
Keyword(s):  
Blood Loss ◽  
Cord Blood ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Postnatal Period ◽  
Controlled Clinical Trial ◽  
Study Group ◽  
Third Stage ◽  
Average Size ◽  
Vertex Presentation

Background: Present study was undertaken to evaluate the effectiveness of placental cord blood drainage after vaginal delivery in reducing the duration and blood loss during third stage of labour in Primi/Multigravida (up to G3) between the age group of 18-35 years, with term, singleton alive pregnancy with vertex presentation, adequate liqour, with average size (estimated foetal weight 2-4Kg) fetus, without any complications, expected to spontaneous vaginal delivery.Methods: It is a randomized clinical controlled trial on 400 pregnant women admitted in labour ward at KGMCH, Asaripallam, Kanyakumari district between January 2015 to December 2015. All women enrolled were subjected to history taking general and obstetric examination. In the study group, placental end of the previously clamped and cut umbilical cord was unclamped immediately after vaginal delivery, while remaining clamped in the control group.Results: Duration of third stage of labour blood loss during third stage postpartum hemorrhage and need for blood transfusion haemoglobin difference between antenatal and postnatal period was significantly reduced in the study group than control group.Conclusions: Placental Cord blood drainage is simple, safe, non-invasive method which reduces the duration and blood loss of third stage of Labour. 

scholarly journals Role of methylergometrine versus oxytocin in the active management of third stage of labour: a randomised control trial

2021 ◽  
Author(s):  
Sabitha Umapathy Srinivasan ◽  
Swarnamukhi P.
Keyword(s):  
Blood Pressure ◽  
Blood Loss ◽  
Active Management ◽  
Randomised Control Trial ◽  
Routine Practice ◽  
Study Group ◽  
Randomized Design ◽  
Third Stage ◽  
The Mean

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.

scholarly journals Cervical traction: a simple step ahead in the prevention of postpartum hemorrhage

2019 ◽  
Vol 8 (8) ◽  
pp. 3174
Author(s):  
Harshita Naidu ◽  
Sujatha B. S. ◽  
Muralidhar V. Pai
Keyword(s):  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Active Management ◽  
Control Group ◽  
Case Group ◽  
Postpartum Blood Loss ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Cervical Traction

Background: Postpartum hemorrhage is the most common preventable cause of maternal mortality in developing countries. The present study aimed to examine the impact of cervical traction technique in reducing the amount of postpartum blood loss and rate of PPH.Methods: This was a case-control, pilot study conducted in a tertiary hospital between June 2017 to June 2018. A total of 200 singletons, low-risk pregnant females, undergoing normal vaginal delivery, were enrolled in this study. Subjects showing a high risk for PPH were excluded. Patients were randomized as case group (n=100) and control group (n=100). The case group received sustained traction for 90 seconds to anterior and posterior lip of the cervix with active management of the third stage of labor, whereas the control group received routine active management of the third stage of labor. All subjects were followed up for 6 hours post-delivery. The amount of blood loss, hematocrit and hemoglobin post-delivery were compared between both groups.Results: The mean blood loss (ml), decrease in hemoglobin (g/L) and decrease in hematocrit post-delivery in cases were significantly low compared to controls (207±37.6 versus 340±49, P<0.01), (0.78±0.2 versus 1.4±0.3, P=0.03) and (1.7±0.2 versus 3.5±0.2, P<0.01). PPH occurred in 7 of 200 (3.5%) patients. The difference in the number of PPH was not significant (5/100; 5% versus 2/100; 2% P=0.2). There were no complications reported due to cervical traction.Conclusions: Cervical traction is a simple and safe maneuver to reduce the amount of postpartum blood loss. Larger RCT is recommended to investigate the reduction in PPH rate.

scholarly journals The efficiency and efficacy of tranexamic acid in prevention of blood loss during or after caesarean delivery: a comparative study

2020 ◽  
Vol 9 (4) ◽  
pp. 1549
Author(s):  
Supriya Raina ◽  
V. Suguna ◽  
Padmaja Prabraju
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Normal Saline ◽  
Test Group ◽  
Normal Vaginal Delivery ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Background: The practice of caesarean section is increasing day by day. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary or secondary postpartum hemorrhage. The aim of present study was to study the efficacy and safety of tranexamic acid in reducing blood loss during and after caesarean section.Methods: This study was conducted at Deccan College of Medical Sciences, Hyderabad. It was a prospective randomized double blind placebo controlled study. This study includes 60 pregnant women divided in to two groups. Just before the induction of anesthesia 1 gm of tranexamic acid in 20 ml of normal saline was given over 10 minutes in test group and 20 ml of normal saline was infused in control group.Results: The demographic characters of patients in two groups were comparable. There was no statistically significant difference in the heart rates, respiratory rates and blood pressures in the two groups. There was statistically significant difference in the quantity of the blood loss from during the operation and 2 hours postpartum (p=0.003). Total mean blood loss in control group was 718.80±233.1 ml and in study group was 554.28±207.8 ml. The drop in hemoglobin after caesarean section in study group was not significant where as in control group was significant. There was no significant difference in the prothrombin time and partial thromboplastin time in the groups, pre and post operatively. In this study the use of tranexamic acid reduced the dose of other uterotonics like syntocin in study group.Conclusions: Tranexamic acid significantly reduced the amount of blood loss during the caesarean section and also reduced the use of other uterotonics. Thus, tranexamic acid can be used safely and effectively in subjects undergoing caesarean section.

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