scholarly journals The management and prevention of post partum Haemorrhage in a clinic

Curationis ◽  
1979 ◽  
Vol 2 (3) ◽  
Author(s):  
J.V. Larsen
Keyword(s):  
Blood Loss ◽  
Genital Tract ◽  
Post Partum ◽  
Post Partum Haemorrhage ◽  
Definition Of ◽  
Excessive Blood Loss

Post-partum haemorrhage is best defined as excessive blood loss from the genital tract following the birth of the fetus. For statistical purposes, the definition of excessive blood loss is 600 ml or more. Traditionally, post-partum haemorrhage is divided into primary PPH which is bleeding occurring within 24 hours of delivery, and secondary PPH which is bleeding occurring after that time.

scholarly journals Post partum haemorrhage: Prevalence, morbidity and management pattern in Dhulikhel Hospital

1970 ◽  
Vol 8 (2) ◽  
pp. 212-215 ◽  
Author(s):  
AS Dongol ◽  
A Shrestha ◽  
CD Chawla
Keyword(s):  
Blood Loss ◽  
Genital Tract ◽  
Post Partum ◽  
Medical Science ◽  
Active Management ◽  
Management Pattern ◽  
Standard Format ◽  
Retained Placenta ◽  
Manual Removal ◽  
Post Partum Haemorrhage

Background: Post partum haemorrhage (PPH) is the leading cause of maternal death worldwide. PPH occurs in up to 18% of total births. Among different factors, PPH due to uterine atony is the primary and direct cause of maternal mortality comprising about 90%. Objective: The objective of the present study was to assess the prevalence, morbidity and management pattern of PPH in Dhulikhel Hospital. Materials and methods: Hospital based retrospective study was carried out at Kathmandu University School of Medical Science, Dhulikhel Hospital from the period of January 2007 till October 2009. The study group included total of 60 patients. All women who had PPH both primary and secondary were studied. Information regarding total number of deliveries obtained from Obstetrics ward. The cases with PPH were identified and detail records were reviewed using standard format. The main outcome measures used for the analysis were amount of blood loss, cause of PPH and treatment methods. Results: In Dhulikhel hospital, from January 2007 till October 2009 a total of 3805 deliveries took place. Out of which 60 women had PPH. The prevalence was 16/1000 deliveries. There are 41 (68.3%) cases of primary PPH and 19 (31.7%) cases of secondary PPH. PPH was found more in home deliveries, unbooked case and in multiparas. The mean blood loss was 1055ml. As an aetiology, retained placenta and retained placental bits of tissue was found in 37(61.7%) cases, atonic uterus in 10 (16.7%) cases, genital tract trauma in 8(13.3%), sepsis of genital tract in 3(5%), case of ruptured uterus in one case and a case of angle bleeding from previous uterine scar following caesarean section. Among all 15 (25%) cases underwent manual removal of placenta, 5(8.3%) underwent controlled cord traction, 3 (5%) underwent manual removal of placenta followed by check curettage in cases of retained placenta, 16 (26.7%) cases were managed by check curettage for retained bits of placental tissue and membrane. Trauma in genital tract was managed by repair of trauma in 6 (10%) cases. Hysterectomy was required in 3 (5%) cases. Conservative management with uterotonics only required in 12 (20%) cases. Conclusion: Active management of third stage of labour can prevent PPH so delivery by skilled hand in hospital should be promoted. Secondary PPH besides primary can result in significant maternal morbidity. It also deserves similar attention. Key words: Atonic uterus; Postpartum haemorrhage DOI: 10.3126/kumj.v8i2.3561 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 212-215

0.11a Tranexamic acid reduces blood loss in post-partum haemorrhage

2011 ◽  
Vol 127 ◽  
pp. S128
Author(s):  
A.-S. Ducloy-Bouthors ◽  
A. Duhameir ◽  
S. Susenr ◽  
F. Broisin ◽  
C. Huissoud ◽  
...  
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Post Partum ◽  
Post Partum Haemorrhage

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 Comparative Study of Rectal Misoprostol to Oxytocin Infusion in Preventing Postpartum Haemorrhage After Caesarean Section

2014 ◽  
Vol 8 (2) ◽  
pp. 34-37 ◽  
Author(s):  
AI Adanikin ◽  
E Orji ◽  
PO Adanikin ◽  
O Olaniyan
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Comparative Study ◽  
Postpartum Haemorrhage ◽  
Post Partum ◽  
Operative Blood Loss ◽  
Oxytocin Infusion ◽  
The Mean ◽  
Post Partum Haemorrhage ◽  
To Receive

Aims: This comparative study aimed to compare the efficacy of rectal misoprostol to oxytocin infusion in preventing primary postpartum haemorrhage after caesarean section. Methods: Fifty pregnant women with identifiable risk factors for post-partum haemorrhage who delivered baby by caesarean section were randomized to receive 600 μg rectal misoprostol and a placebo infusion intravenously or placebo rectally and a 20 iu oxytocin infusion. Post-operative blood loss four hours after surgery was estimated by application of pads of known weight. Results: The mean immediate four hours post-operative blood loss was not significantly different between the rectal misoprostol and oxytocin infusion group (100.08 ± 24.85 ml versus 108.20 ± 29.93 ml; p =0.144) and the change between the pre-operative and post-operative hematocrit was similar. Conclusions: Post-caesarean section rectal misoprostol has comparative efficacy to oxytocin infusion in preventing post-partum haemorrhage. It is recommended for use as alternative uterotonic in settings where there is low refrigeration capacity.Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 2 / Issue 16 / July-Dec, 2013 / 34-37 DOI: http://dx.doi.org/10.3126/njog.v8i2.9767

scholarly journals POST PARTUM HAEMORRHAGE PROPHYLAXIS

2008 ◽  
Vol 15 (03) ◽  
pp. 323-327
Author(s):  
ALIYA ISLAM ◽  
ASIFA SIRAJ ◽  
NADIA ARIF
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Military Hospital ◽  
Standard Size ◽  
Group I ◽  
Significant Difference ◽  
Post Partum Haemorrhage ◽  
Group Ii ◽  
Group 2

Post partum hemorrhage (PPH) is defined as the loss of greater than 500ml of blood from the genitaltract in the first 24 hours following delivery. PPH occurs in 2-11% of all deliveries. Objective: To compare the efficacyof misoprostol and ergometrine for the prophylaxis of Post Partum Haemorrhage. Design: Prospective study. Setting:Gynaecology and Obstetrics Department Military Hospital Rawalpindi. Period: From 01 July 2006 to 31 Dec 2006.Patients & Methods: A total of 200 patients were recruited in the study, they were divided in two groups, group – I (n100) included those patients who were administered ergometrine intravenously at the time of delivery of head for theprophylaxis of post partum haemorrhage, Group – 2 (n-100) included those patients who were administered Misoprostol800 microgram per rectally just before the start of cesarean section for the same purpose. Blood loss was calculatedobjectively by squeezing the soaked pads and quantifying the amount of clots in a kidney tray of standard size to beequal to 500ml.Results: In group I (n-100) 15 patients had mild PPH blood loss >500ml, out of them 03 had severePPH requiring bimanual message and 02 patients required blood transfusion, in group II( n-100). 08 patients had PPH,blood loss >500 ml, out of them 01 patient required uterine message and none required blood transfusion. Chi-squaretest was applied to compare the efficacy of the two groups, P>0.05 showed no significant difference in the efficacy ofthe two groups but the side effects were obviously less in the Misoprostol group. No patient in group II had GI symptomswhile 36 patient in group I had retching and, vomiting and 03 patients had raised B.P after the administration ofergometrine. Conclusion: Misoprostol administered per rectally has equal efficacy to ergometrine given intravenouslyfor the prophylaxis of post partum haemorrhage but the side effect profile and patient tolerability is better withMisoprostol.

scholarly journals A randomised controlled study for the prevention of post-partum haemorrhage with oxytocin plus methyl ergometrine versus oxytocin alone in the third stage of labour

2021 ◽  
Vol 10 (5) ◽  
pp. 1906
Author(s):  
Rajani Somanathan ◽  
Mohanapriya Balu ◽  
Elizabeth Jacob ◽  
Sr Marykutty Illickal
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
Controlled Study ◽  
The Third ◽  
Combined Use ◽  
Randomised Controlled Study ◽  
Third Stage ◽  
Post Partum Haemorrhage ◽  
The Difference ◽  
Randomised Controlled

Background: Postpartum haemorrhage is the leading cause of maternal death. Uterine atony which is preventable, causes 80% of Post partum haemorrhage (PPH). Active management of third stage of labour (AMTSL) lowers maternal blood loss and reduces the risk of PPH. In this open labelled randomised controlled study we compared the combined use of oxytocin and methyl ergometrine vs oxytocin alone in prevention of PPH in the third stage of labour.Methods: 200 Women admitted for safe confinement and following the inclusion criteria were randomised immediately post delivery to receive either oxytocin +methyl ergometrine or oxytocin alone. The amount of blood loss was assessed objectively by weighing the mops and under sheets used during delivery. If bleeding could not be controlled, additional uterotonics were given. The incidence of PPH, amount of blood loss, use of additional uterotonics and side effects were recorded. The difference in pre natal and post natal haemoglobin (Hb) and the need for blood transfusion were assessed.Results: There was no statistically significant difference in the incidence of PPH between the groups. Post partum blood loss was significantly lesser in the combined group. Additional oxytocics were required more often in the oxytocin only group. The incidence of headache was significantly more in the combined group. The difference in haemoglobin levels post natally and the need for blood transfusion was comparable among both groups.Conclusions: The combined use of methyl ergometrine +oxytocin is not recommended over oxytocin alone in the third stage of labour for prevention of PPH.

scholarly journals Measuring Post-Partum Haemorrhage in Low-Resource Settings: The Diagnostic Validity of Weighed Blood Loss versus Quantitative Changes in Hemoglobin

PLoS ONE ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. e0152408 ◽  
Author(s):  
Esther Cathyln Atukunda ◽  
Godfrey Rwambuka Mugyenyi ◽  
Celestino Obua ◽  
Elly Bronney Atuhumuza ◽  
Nicholas Musinguzi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
Diagnostic Validity ◽  
Low Resource Settings ◽  
Low Resource ◽  
Post Partum Haemorrhage ◽  
Quantitative Changes

scholarly journals A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

2017 ◽  
Vol 6 (5) ◽  
pp. 1960 ◽  
Author(s):  
Anjuman Alam ◽  
Paresh Shyam ◽  
Swapnil Goswami
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
Active Management ◽  
Singleton Pregnancy ◽  
Primary Parameter ◽  
Third Stage ◽  
Drug Storage ◽  
Trained Personnel ◽  
Post Partum Haemorrhage ◽  
Spontaneous Onset

Background: To compare the efficacy of oxytocin, methylergometrine and misoprostol in active management of third stage of labour (AMTSL).Methods: A clinical study was conducted on 330 low risk pregnant women with a healthy singleton pregnancy and spontaneous onset of labour at term; allocated into three groups where active management of third stage of labour was done with either Oxytocin 10 IU intramuscular, or Methylergometrine 0.2 mg intramuscular, or tab Misoprostol 600µg sublingual on 110 women each group. Primary parameter was blood loss during labour. Secondary parameters were the duration of third stage of labour and changes in haemoglobin level.Results: Blood loss during labour in Oxytocin group was 145.86±11.53 ml, which was significantly less than that in Methylergometrine (164.02±9.36 ml) and Misoprostol groups (183.18±9.70 ml), but no patient in any of the groups had blood loss more than 200ml. Duration of third stage of labour was significantly less in Oxytocin group (5.13±1.91 mins) than in. Methylergometrine (6.16±1.85 mins), and Misoprostol groups (6.47±1.51 mins). No patient had prolonged third stage in any of the groups. There was no significant change in pre-and post-delivery haemoglobin levels in all the groups.Conclusions: Though injectable uterotonics are effective for active management of third stage of labour (AMTSL), misoprostol can also be effectively used, especially in settings where there is no adequate trained personnel and drug storage facility.

scholarly journals Experience with surgical options for managing atonic post-partum haemorrhage

1970 ◽  
Vol 3 (1) ◽  
pp. 10-13
Author(s):  
Rachana Saha ◽  
Chanda Karki ◽  
Saraswati M Padhye
Keyword(s):  
Genital Tract ◽  
Post Partum ◽  
Artery Ligation ◽  
Maternal Deaths ◽  
Single Procedure ◽  
Uterine Artery Ligation ◽  
Surgical Methods ◽  
Surgical Options ◽  
Post Partum Haemorrhage ◽  
Placenta Accrete

Aim: To analyse the measures taken for controlling primary Post-partum haemorrhage (PPH). Methods: A hospital based descriptive and retrospective study was carried out from 1st January 2005 to 31st December 2006 in the department of Obstetrics & Gynaecology at KMCTH. All patients of having primary Post-partum haemorrhage were analysed for the treatment they received. Results: There were 15 cases of primary Post-Partum Haemorrhage (PPH) from a total delivery of 700 in the year 2005. 9 cases were solely of atonic post-partum haemorrhage. 2 cases were genital tract injuries, 1 case of retained placenta, 1 case of vulval haematoma and 2 cases were of combined cervical tear and atonic primary post-partum haemorrhage. Atonic post-partum haemorrhage remained most important cause. The most common treatment was use of oxytocic. Surgical procedure bilateral uterine artery ligation was frequently performed in 6 cases but it was not effective as a single procedure. B-Lynch brace suture was applied in 5 cases and was successful without further intervention. There were 2 maternal deaths from post-partum haemorrhage. In the year 2006 total number of deliveries was 835 and there were total 11 cases of post partum haemorrhage. The trend changed to from atonic PPH to traumatic PPH. There were 8 cases of traumatic PPH and there were 2 cases of placenta accrete. There was one case of atonic PPH. The overall incidence in two years was 1.6%. Conclusion: Among the various surgical methods adopted B-Lynch brace suture was found to be simple, effective and minimally invasive. Keywords: Atonic post-partum haemorrhage (PPH), surgical management of PPH.  doi:10.3126/njog.v3i1.1432 NJOG 2008 May-June; 3(1): 10 - 13

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