THE THIRD STAGE OF LABOUR AND POST‐PARTUM HÆMORRHAGE, WITH OBSERVATIONS ON THE USE OF PITOCIN

1954 ◽  
Vol 1 (4) ◽  
pp. 118-121 ◽  
Author(s):  
W. McBride
Keyword(s):  
Post Partum ◽  
The Third ◽  
Third Stage ◽  
Post Partum Haemorrhage

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 Effect of Postpartum Gymnastics on Decreasing Height of Uterine Fundus in Post Partum Mothers in BPM Midwife Susi Irma Navia, S.ST Bengkulu City

2019 ◽  
Vol 26 (1) ◽  
pp. 70-78
Author(s):  
Vellyza Colin ◽  
Buyung Keraman ◽  
Atika Dwi Sundari
Keyword(s):  
Standard Deviation ◽  
Post Partum ◽  
Experimental Sample ◽  
Demographic Health Survey ◽  
Early Ambulation ◽  
The Third ◽  
Exercise Effect ◽  
Post Partum Haemorrhage ◽  
Postpartum Mothers ◽  
Uterine Fundus

One of causes of the high maternal mortality rate by Indonesia Demographic Health Survey (IDHS)  is post-partum haemorrhage (20%). No smooth involution adversely affects postpartum bleeding. Early ambulation such as postpartum exercise facilitates a normal involution. This study aims to study the effect of puerperal gymnastics on the reduction of uterine fundus height among post partum mothers at BPM Bidan Susi Irma Navia, S.ST Bengkulu City. This study used a pre experiment design. The population in this study were all postpartum mothers in BPM Bidan Susi Irma Navia, S.ST Bengkulu City on June 22-July 22 2018 as many as 24 mothers. The sample in this study there were 2 groups, namely the maternal maternal experimental sample that did postpartum gymnastics and the non-maternal maternity samples which did not do puerperal gymnastics. The results of the study were: (1) In mothers who did not do childbirth, on the third day the minimum uterine fundal height was 7 cm, uterine fundus height was maximum 10 cm and uterine fundal height was an average of 8.50 cm with a standard deviation of 1.087. While on day 5, the minimum uterine fundus was 4 cm, uterine fundus height was maximum 8 cm and uterine fundal height was 5.67 cm with a standard deviation of 1.073; (2) In women who had postnatal exercise, on the third day of fundus height the minimum uteri is 7 cm, uterine fundus height is maximum 9 cm and uterine fundal height is an average of 7.83 cm with a standard deviation of 0.718. Whereas on day 5 the uterine fundal height was minimum 3 cm, uterine fundus height maximum 5 cm and uterine fundal height averaged 4.00 cm with a standard deviation of 0.739; (3) On the 3rd day there was no postpartum exercise effect on the decrease in uterine fundus height in post partum mothers at BPM Bidan Susi Irma Navia, S.ST Bengkulu City; (4) On the 5th day there was the influence of puerperal gymnastics on decreasing uterine fundus height in post partum mothers at BPM Bidan Susi Irma Navia, S.ST Bengkulu City.Keywords: fundus uteri, postpartum gymnastics, postpartum mother

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 Active management of third stage of labour, post–partum haemorrhage and maternal death rate in the Vanga Health Zone, Province of Bandundu, Democratic Republic of the Congo

2010 ◽  
Vol 2 (1) ◽  
Author(s):  
Jean-Pierre Fina Lubaki ◽  
Jean-Robert Musiti Ngolo ◽  
Lucie Zikudieka Maniati
Keyword(s):  
Maternal Death ◽  
Democratic Republic ◽  
Post Partum ◽  
Active Management ◽  
Maternal Deaths ◽  
Third Stage ◽  
Post Test ◽  
Republic Of The Congo ◽  
Health Zone ◽  
Post Partum Haemorrhage

Background: Post-partum haemorrhage (PPH) is the single largest cause of maternal death worldwide and a particular burden for developing countries. In Africa, about 33.9 % of maternal deaths are due to PPH. In the Democratic Republic of the Congo (DRC), the prevalence of PPH is unknown. PPH can be prevented with active management of the third stage of labour (AMTSL). Objectives: To describe the practice of AMTSL in Vanga Health Zone and to calculate the incidence of PPH in Vanga Health Zone.Method: An intervention study with post-test-only design was conducted among health maternity wards using a data collection sheet to obtain information. All pregnant women attending Vanga Health maternity wards constituted the study population. Frequencies were determined for variables of interest.Results: From April 2007 to March 2008, 6339 deliveries took place at Vanga Health maternity wards, representing 71% of the institutional delivery rate. The number of deliveries realised with the practice of (AMTSL) were 5562; 366 cases of PPH were reported, making an incidence of 5.77%. Three cases of maternal deaths – two of which were related to PPH – were reported during the study period, which means there was a decline of 70% compared with the previous two years.Conclusion: The prevalence of PPH has been estimated to be 5.77%; PPH represents the cause of 67% of all maternal deaths. The extension of AMTSL practice, combined with the assurance of better supplies of oxytocin to enhance drug management, is strongly advised/suggested. As a number of births still take place outside the health maternity wards, the introduction of oral misoprostol could be considered a part of AMTSL for use by patients being treated by traditional midwives.

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