scholarly journals OBSTETRIC CHOLESTASIS

2003 ◽  
Vol 41 (142) ◽  
pp. 335-340
Author(s):  
Pramila Pradhan
Keyword(s):  
Perinatal Mortality ◽  
Maternal Morbidity ◽  
Post Partum ◽  
Active Management ◽  
Close Monitoring ◽  
The Third ◽  
Oestrogen Level ◽  
Increased Risk ◽  
Third Stage ◽  
In Pregnancy

Obstetric Cholestasis is the commonest liver disease that causes pruritis and is uniqueto pregnancy. Pruritis can be so intense as to lead insomnia.The Significance of thisdisease has been highlighted more recently due to the associated perinatal mortalityand maternal morbidity. Aetiology and pathophysiology still uncertain. There, appearsto be genetic predisposition in certain individuals resulting in an increasedsusceptibility to the high oestrogen levels found in pregnancy specially in 3rdtrimesterand resolving promptly after delivery when oestrogen level falls rapidly. Pruritis iscentral in origin and thus fails to respond to commonly used antihistamines and lotiocalamine locally. Recently ursodeoxycholic acid an exogenous bile acid is increasinglybeing used and showed improved both pruritis and liver function and favourablechanges were observed in the foetus as well. Delivery planned at 37-38 weeks ofgestation reduced perinatal mortality. Because of increased rate of adverse intrapartumevents, close monitoring is appropriate. Active management of the third stage isnecessary because of the increased risk of post partum haemorrhage.Key Words: Pruritis, pregnancy, planned delivery, perinatal mortality and maternal morbidity.

scholarly journals Comparison of Oral Misoprostol with Intramuscular Oxytocin in the Active Management of Third Stage of Labour

2015 ◽  
Vol 10 (1) ◽  
pp. 76-80
Author(s):  
S Kaudel ◽  
A Rana ◽  
N Ojha
Keyword(s):  
Blood Transfusion ◽  
Post Partum ◽  
University Teaching ◽  
Active Management ◽  
The Third ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B

Aims: This study aimed at comparing the efficacy of oral misoprostol 600 mcg with intramuscular oxytocin 10 IU in the active management of third stage of labour. Methods: This prospective comparative study was performed in Tribhuvan University Teaching Hospital to compare the efficacy of oral misoprostol with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage. One hundred and twenty women without risk of PPH were randomly allocated to receive either 600 mcg misoprostol orally (Group A) or 10 unit of oxytocin intramuscularly (Group B) within 1 minute of delivery. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in hemoglobin (Hb) and hematocrit (Hct) level from before delivery to 8 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Oral misoprostol was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage (PPH). There was no statistical difference in the duration of third stage of labour, need for additional uterotonics, need for uterine exploration/evacuation and need for blood transfusion in the two groups. Conclusions: Routine use of oral misoprostol 600 mcg appears to be as effective as 10 IU intramuscular oxytocin in minimizing blood loss during the third stage of labour.

scholarly journals Active management of third stage of labour with low doses of oral misoprostol and oxytocin on low: risk parturient in a Sub-Saharan hospital, Dakar, Sénégal

2017 ◽  
Vol 6 (2) ◽  
pp. 516 ◽  
Author(s):  
Moussa Diallo ◽  
Toura Sylla ◽  
Abdoul Aziz Diouf ◽  
Phillipe Marc Moreira ◽  
Omar Gassama ◽  
...  
Keyword(s):  
Average Rate ◽  
Post Partum ◽  
Low Risk ◽  
University Hospital ◽  
Active Management ◽  
Controlled Clinical Trial ◽  
The Third ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Misoprostol Group

Background: Assess the effectiveness of oral misoprostol as an alternative to oxytocin in the active management of the third stage of labour in Dakar/Senegal.Methods: Randomized controlled clinical trial conducted in the maternity ward of a university hospital on 304 women who had vaginal delivery. These women were randomly assigned into 2 groups based on active delivery conditions: the first group received an oral administration of misoprostol (400 mcg) and the second group 5 IU oxytocin through intravenous route.Results: The average volume of blood loss was 196.55 ml in the misoprostol group and 208.39 ml in the oxytocin group (p=0.63). The incidence of postpartum haemorrhage (>500 cc) was 6.49% in the misoprostol group and 9.33% in the oxytocin group (p=0.358). The average rate of haemo globin decline was 0.38 g/dl in the misoprostol group and 0.29 g/dl in the oxytocin group (p=0.99). The proportion of hyperthermia, shivering, and nausea in the misoprostol and oxytocin groups were respectively: 2.59% against 0.6% (p=0.123), 7.14% against 2% (p=0.001) and 2.59% against 0.6% (p=0.498).Conclusions: In Senegal, Misoprostol despite its side effects, is an effective alternative to oxytocin in the active management of the third stage of labour for low-risk parturient women to reduce the risk of maternal deaths due to post-partum hemorrhage.

scholarly journals Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Fiona Urner ◽  
Roland Zimmermann ◽  
Alexander Krafft
Keyword(s):  
Maternal Morbidity ◽  
Placenta Previa ◽  
Morbidity And Mortality ◽  
Active Management ◽  
Retained Placenta ◽  
Manual Removal ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Maternal Morbidity And Mortality

The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity.

scholarly journals Intramuscular oxytocin 10 units versus intravenous methylergometrine 0.2 mg in active management of third stage of labour for prevention of postpartum haemorrhage: a comparative study

2020 ◽  
Vol 9 (2) ◽  
pp. 494
Author(s):  
Divya Narayana ◽  
B. Pathak ◽  
Abha Khurana ◽  
Uttara Aiyer Kohli
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Tertiary Care ◽  
Active Management ◽  
Normal Delivery ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

Background: To compare the effectiveness of 10 IU of oxytocin IM with 0.2 mg methyl ergometrine IV in the prevention of post-partum hemorrhage when used as a part of active management of third stage of labour. This study aims to compare their influence on duration of the third stage of labour, the amount of blood loss during the third stage of labour and the immediate post-partum period and side effects of the drugs if any.Methods: The study was conducted in a tertiary care teaching hospital. 200 women, who underwent normal delivery with or without episiotomy, were enrolled and were randomly distributed into two groups. 100 women received 10 IU of intramuscular Oxytocin and 100 women received intravenous 0.2 mg of methyl ergometrine. Women of both the groups were given the medication after delivery of anterior shoulder of the baby. Comparison done between percentages fall in Hb from before delivery to 24 hours after delivery, need for additional uterotonic agents, need for blood transfusion, duration of third stage of labour and any side effects including retained placenta and need for manual removal of placenta.Results: Intravenous methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage. There was no difference in the duration of third stage of labour, amount of blood loss, need for additional uterotonic agents, and need for blood transfusion in both the groups. There was no significant side effect in both the groups.Conclusions: Intramuscular oxytocin is as efficacious as Intravenous methylergometrine in the prevention of postpartum hemorrhage with no side effects.

scholarly journals Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin

1970 ◽  
Vol 2 (2) ◽  
pp. 24-28 ◽  
Author(s):  
Shilu Adhikari ◽  
Ashma Rana ◽  
Kesang D Bista
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Statistical Significance ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
The Third ◽  
Third Stage

Aim: Aimed at comparing the efficacy of prophylactic intramuscular methylergometrine with intramuscular oxytocin in reducing blood loss in the third stage of labour (TSL). Methods: This is a randomized, comparative, clinical trial to compare the efficacy of intramuscular methylergometrine with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage Two hundred women undergoing normal vaginal delivery were recruited, 100 in each group- Group A receiving .2mg methylergometrine intramuscularly and Group B receiving 10U oxytocin intramuscularly immediately after the delivery of the anterior shoulder of the baby. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in haemoglobin (Hb) and haematocrit (Hct) level from before delivery to 24 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Intramuscular methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post partum haemorrhage (PPH) [defined as fall in Hb and /or Hct level³ 10% from before delivery to 24 hours after delivery]. There was no difference in the risk of prolonged third stage, need for additional uterotonic agents, need for exploration and uterine evacuation and need for blood transfusion in the two groups. The side effects were all mild in nature and the overall incidence was too low for statistical significance to be elicited. Conclusion: Intramuscular methylergometrine is as efficacious as intramuscular oxytocin in the prevention of third stage blood loss with comparable side effects. Keywords: Third stage of labour, postpartum hemorrhage, methylergometrine, oxytocin.   doi:10.3126/njog.v2i2.1451   N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 24 - 28

scholarly journals Carbetocin and Oxytocin in the Active Management of third Stage of Labor after Vaginal Birth of Baby

2017 ◽  
Vol 46 (1) ◽  
pp. 7-10
Author(s):  
Hena Rani Barua ◽  
Rita Rani Barua ◽  
Sushanta Barua ◽  
Ajoy Kishore Barua ◽  
Kohinoor Begum
Keyword(s):  
Post Partum ◽  
Active Management ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
The Third ◽  
Third Stage Of Labor ◽  
Significant Difference ◽  
Third Stage ◽  
Group 2 ◽  
Group 1

Postpartum hemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labor has been proven to be effective in the prevention of PPH. Carbetocin; a long-acting Oxytocin agonist appears to be a promising agent for the prevention of PPH. In this study Carbetocin is used for the active management of third stage of labor to prevent PPH. Two hundred pregnant women from July 2015 to December 2015 at Rangamati Medical College Hospital, Rangamati, Bangladesh were included in this study. The patients were divided into two groups: Group- 1 (100 women) were received 100μg Carbetocin intravenously and group- 2 (100 women) received 10 IU Oxytocin intramuscularly and both doses were single. These uterotonics were injected at anterior shoulder after the delivery of the baby. Significant difference was observed between the Carbetocin and Oxytocin receiving groups regarding amount of blood loss (335.70 ± 117.71 versus 375.12 ± 145.30), PPH (3 % versus 12%), need of use of other uterotonics (18% versus 30%) and the difference in hemoglobin percent before and after delivery (0.58 ± 0.34 versus 0.97± 0.52). All these parameters were lower in Carbetocin group except hemoglobin level which is higher in group- 2 during 24 hours after delivery. Moreover, blood transfusion was not indicated in group- 1. In conclusion, Carbetocin is superior to Oxytocin in prevention of post partum hemorrhage at the third stage of vaginal delivery with minimal homodynamic changes and side effects.Bangladesh Med J. 2017 Jan; 46 (1): 7-10

scholarly journals HUBUNGAN MANAJEMEN AKTIF KALA III DENGAN KEJADIAN PERDARAHAN POST PARTUM PRIMER DI PBM UMI SURABAYA

2020 ◽  
Vol 3 (1) ◽  
pp. 35
Author(s):  
Sulenti Widiastutik
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Post Partum ◽  
Sampling Technique ◽  
Active Management ◽  
Chi Square ◽  
Cross Sectional ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

ABSTRAK ABSTRAK         Manajemen akif kala III merupakan suatu intervesi yang sangat penting dilakukan pada setiapasuhan persalinan normal dengan tujuan menurunkan angka kemati ibu. Sebagian besar kasus perdarahan terjadi selama persalinan kala III salah satunya seperti atonia uteri.         Dalam penelitian ini menggunakan metode analitik observasional, dengan desain penelitian ini bersifat “ cross sectional “ populasi penelitian ini sebanyak  60 ibu bersalin di PBMUmi Surabaya.Hasil penelitian menunjukkan bahwa manajemen aktif kala III dilakukan dengan sempuirna sebanyak 36 ibu  bersalin.(60%) dan ibu bersalin yang tidak mengalami perdarahan post partum primer sebanyak 33 ibu (55%) Populasi dalam penelitian ini adalah semua ibu  yang bersalin di PBM Umi Surabayadengan besar sampel sebanyak 60 ibu bersalin dengan tehnik total sampling.Dari hasil analisis data menggunakan chi square menunjukkan hasil   hitung (21,237) >  tabel (3,84) = Ho ditolak H1 diterima. Sehingga ada hubungan manajemen aktif kala III dengan kejadian perdarahan post partum primer di PBM Umi Surabaya        Upaya percepatan penurunan  AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu yang berkwalitras, seperti pelayanan kesehatan ibu hamil, pertolongan persalinan oleh tenaga kesehatan terlatih, dan perawatan pasca persalinan ibu dan bayi, perawatan khusus dan rujukan jika terjadi komplikasi Kata kunci Manajemen aktif kala III, Perdarahan Post Paetum PrimerABSTRACTThe third stage of active management is a very important intervention performed in every normal childbirth care with the aim of reducing maternal mortality. Most cases of bleeding occur during the third stage of labor such as uterine atony.         In this study using observational analytic methods, the design of this study is "cross sectional" in this study population of 60 women giving birth in PBM Umi Surabaya.The results showed that the active management of the third stage was carried out with up to 36 mothers (60%) and women who did not experience primary post partum hemorrhage as many as 33 mothers (55%). a large sample of 60 mothers with total sampling technique. From the results of data analysis using chi square showed the results of X2 count (21,237)> X2 table (3.84) = Ho rejected H1 accepted. So there is an active management relationship between the third stage and the incidence of primary post partum hemorrhage at PBM Umi Surabaya        Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services, such as health services for pregnant women, delivery assistance by trained health workers, and postpartum care for mothers and babies, special care and referrals if complications occur. Keywords Active management stage III, Primary Post Partum Bleeding

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