uterine massage
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Author(s):  
Labib M. Ghulmiyyah ◽  
Alaa El-Husheimi ◽  
Ihab M. Usta ◽  
Cristina Colon-Aponte ◽  
Ghina Ghazeeri ◽  
...  

Objective This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery. Study Design This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage. Results A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79). Conclusion There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery. Key Points


2021 ◽  
Vol 8 (8) ◽  
pp. 31-39
Author(s):  
Aparajita Kundu ◽  
Manasi Jana

The most common cause of maternal death worldwide is postpartum hemorrhage (PPH) and Active Management of Third Stage of Labour (AMTSL) is the most important prophylactic intervention for prevention of PPH. A study was undertaken to assess the effect of AMTSL with and without uterine massage on maternal outcome among postnatal mothers in a selected hospital, WB. In this quasi-experimental study, Total 60 (Experimental Group-30, Control Group-30) postnatal mothers who undergone spontaneous vaginal delivery were selected by non-probability purposive sampling technique followed by randomization. The uterine massage is applied for 1 min immediately after placental delivery to 2 hours of postpartum at every 15 mins interval. The results revealed that there was no statistically significant difference of mean amount of postpartum bleeding between experimental and control group at 1st hour, 2nd hour, 24 hours, and 48 hours [t1= 1.06, t2= 1.52, t3=0.47, t4=0.26 at df (58), p>0.05]. The general condition (BP, Pulse, Respiration) after 1st hour, 2nd hour, 24 hours and 48 hours were comparable and statistically not significant between the two groups. There was no significant association between amount of postpartum bleeding and obstetrical parameters like parity, gravida, POG, presence of episiotomy, birth weight, time of placental delivery, presence of tear and time of initiation of breast feeding etc. for both groups. Based on the results of the current study, it can be concluded that the mothers who received the uterine massage along with AMTSL get no additional benefit as compared to control group. Keywords: Active management of third stage of labour (AMTSL); Uterine massage; Maternal outcome; Postnatal mother.


Author(s):  
Reyhan Erkaya ◽  
Özlem Karabulutlu ◽  
Kıymet Yeşilçiçek Çalik

2021 ◽  
Vol 8 (2) ◽  
pp. 270-272
Author(s):  
Paapa Dasari ◽  
Ashraf M Ali

A 30-year-old primigravida who conceived following ICSI (Intra Cytoplasmic Sperm Injection) was admitted at 34 weeks of pregnancy with singleton fetus in breech presentation with Gestational diabetes and Gestational hypertension. To start with Quintuplets were diagnosed and she underwent fetal reduction of 3 foetuses at 14 weeks of pregnancy. Follow up USG revealed only one live fetus after one week. At LSCS (Lower Segment Caesarean Section) performed at 37 weeks, the placenta was found to be adherent and was manually removed. There was profuse bleeding after removal of placenta which was not controlled with uterine massage and uterotonics. Placental examination showed 3 fetus payraeceae. Intrauterine examination revealed an adherent fetus which was removed following which the haemorrhage stopped. In pregnancies following fetal reduction, postpartum haemorrhage can result due to retained fetus papyraceus and hence it is essential to make sure all papyraceae were removed.


2021 ◽  
Vol 21 (1) ◽  
pp. 304-10
Author(s):  
Doris Mumbi Muthoni ◽  
Priscilla Njeri Kabue ◽  
Elizabeth Kurwa Ambani

Background: Postpartum hemorrhage is the cumulative blood loss of 500 milliliters or more in a spontaneous vaginal delivery and approximately 1,000 milliliters or more for caesarean section birth and a leading cause of maternal mortality1. Objective: The overall aim of the study was to determine midwives’ factors that influence the management of PPH. Methods: A descriptive cross-sectional study that employed a quantitative approach through the use of a research self- ad- ministered questionnaire and an observational checklist targeting midwives were used. 85 midwives filled the questionnaire and 71 were observed respectively. The study was hospital- based conducted in Muranga County, Kenya. Convenience sam- pling technique was used to select the midwives in the study sites. Results: The following factors were statistically significant in influencing management of postpartum hemorrhage; age (P-value = 0.021). professional qualification ( P= 0.047), experience in management of PPH ( P= 0.032) and training on emergency PPH ( P= 0.010), knowledge factors that were found to influence the management of PPH positively include knowledge on; prevention of PPH (p value-0.000), correct use of prophylactic uterotonic agents ( P= 0.000), uterotonics use ( P= 0.043), uterine massage during 3rd stage of labour ( P= 0.012), examination of the placenta ( P= 0.034), management of PPH (P= 0.028), causes and diagnosis of PPH ( P= 0.001), (Fischer’s exact value= 0.043). Conclusion: Results of the study indicate a statistical association between midwives’ factors and management of PPH. Keywords: Midwifery factors; management of postpartum haemorrhage.


Author(s):  
Shitong Zhang ◽  
Xianhu Fu

Abstract Background/Objective To estimate the effectiveness of uterine massage UM in reducing blood loss before delivery of placenta in CS. Methods This was a retrospective cohort study of 1393 women who delivered with CS. Patients who underwent UM (671women) were compared with those who underwent controlled cord traction (722 women). According to risk assessment of PPH, 2 groups were both divided to low risk group and high risk group. Outcomes included blood loss amount within 2 h after delivery, incidence of PPH and intractable PPH. Results Blood loss amount within 2 h was lower in UM group than CCT group(516.6±196.5 ml compared with 674.1±272.2 ml, P<0.01). The incidence of PPH and intractable PPH didn’t differ significantly between the 2 groups (6.7% compared with 9.1%, P=0.09 and 3.9% compared with 5.3%, P=0.22,respectively).In high risk group, the amount of blood loss within 2 h and the incidence of PPH were both lower in UM group (n=382) than CCT group (n=407) (576.8±228.1 ml compared with 854.9±346.1 ml, P<0.01 and 7.1% compared with 11.3%,P=0.04 ,respectively). The incidence of intractable PPH didn’t differ significantly between the 2 groups (4.7% compared with 6.9%,P=0.19). In low risk group, the 3 outcomes didn’t differ significantly between the 2 groups(n=289 vs. 315) (428.5±172.6 ml compared with 447.9±180.5 ml; 6.2% compared with 6.3%; 2.8% compared with 3.2%; P=0.56, 0.95 and 0.77,respectively). Conclusion In high risk patients of PPH, UM before delivery of placenta contributed to reduce blood loss in CS.


2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kate Abraham ◽  
Sajel Nuwamanya ◽  
Malia Swanson ◽  
Jenny Kendall ◽  
Shelley Waits

2019 ◽  
Vol 13 (1) ◽  
pp. 236
Author(s):  
Rita de Cássia de Oliveira ◽  
Rejane Marie Barbosa Davim

ABSTRACTObjective: to identify the evidence on the prevention and treatment of postpartum haemorrhage in health care. Method: this is a descriptive and quantitative bibliographical study of the type integrative, with temporal delimitation from 2007 to 2017, with a search in the databases LILACS, MEDLINE and SciELO Virtual Library, and the results are presented in figure, analyzed by the technique of Content Analysis in the Thematic Analysis modality. Results: totaling 100 articles, which, after refinement, totaled 11 eligible for discussion with the literature. Conclusion: the correct management of the third stage of labor with the prophylaxis of postpartum haemorrhage was fundamental, based on the use of uterotonic drugs, controlled cord traction and uterine massage in place of clamping of the cord. Descriptors: Pregnant women; Pregnancy; Bleeding; Maternal Mortality; Puerperal infection; Women's Health.RESUMOObjetivo: identificar as evidências sobre a prevenção e o tratamento da hemorragia pós-parto em cuidados no campo da saúde. Método: trata-se de um estudo bibliográfico, descritivo e quantitativo, do tipo revisão integrativa, com delimitação temporal de 2007 a 2017, com busca nas bases de dados LILACS, MEDLINE e Biblioteca Virtual SciELO, e os resultados se apresentam em figura, analisados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: totalizaram-se 100 artigos que, após refinamento, totalizaram 11 elegíveis para discussão com a literatura. Conclusão: evidenciou-se que é fundamental o manejo correto no terceiro estágio do trabalho de parto, com a profilaxia da hemorragia pós-parto, tendo como base o uso de drogas uterotônicas, a tração controlada de cordão e a massagem uterina em substituição ao clampeamento do cordão. Descritores: Gestantes; Gravidez; Hemorragia; Mortalidade Materna; Infecção Puerperal; Saúde da Mulher.RESUMENObjetivo: identificar las evidencias sobre la prevención y el tratamiento de la hemorragia posparto en cuidados en el campo de la salud. Método: se trata de un estudio bibliográfico, descriptivo y cuantitativo, del tipo revisión integrativa, con delimitación temporal de 2007 a 2017, con búsqueda en las bases de datos LILACS, MEDLINE y Biblioteca Virtual SciELO, y los resultados se presentan en figura, analizados por la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se totalizaron 100 artículos que, después de refinamiento, totalizaron 11 elegibles para discusión con la literatura. Conclusión: se evidenció que es fundamental el manejo correcto en la tercera etapa del trabajo de parto, con la profilaxis de la hemorragia posparto, teniendo como base el uso de drogas uterotónicas, la tracción controlada de cordón y el masaje uterino en sustitución al clampeamiento del cordón. Descriptores: Mujeres Embarazzadas; Embarazzo; Hemorrragia; Infección Puerperal; Salud de la Mujer.


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