Uterine massage for preventing postpartum haemorrhage

Hofmeyr, G Justus; Abdel‐Aleem, Hany; Abdel-Aleem, Mahmoud A

doi:10.1002/14651858.cd006431.pub3

Cited by 49 publications

(17 citation statements)

References 11 publications

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“…The majority of the participating centers have previously worked together in a French multicenter randomized controlled trial that aimed to assess the effect of controlled traction of the cord on the prevention of PPH (TRACOR trial) [17]. During a one-year period, they together randomized 4068 women with vaginal deliveries and demonstrated their capacity to conduct and perform a RCT regarding the prevention of PPH.…”

Section: Methods and Designmentioning

confidence: 99%

“…An inclusion period of 20 months should make it possible to recruit 4,000 women, if we assume a participation rate of at least 17.2 %. This participation rate appears realistic in light of the recruitment in the TRACOR trial in the labor wards of all the participating centers [17]. …”

Section: Methods and Designmentioning

confidence: 99%

“…Active management of the third stage of labor (AMTSL) comprises a combination of mechanical interventions: preventive administration of uterotonic agents immediately after delivery of the child, early cord clamping and cutting, controlled cord traction (CCT), and, according to some authors, uterine massage [12]. Nevertheless, it has been clearly shown that the administration of uterotonics, and in particular oxytocin, after birth is the only component of AMTSL that is effective in preventing PPH [13–17]. However, in addition to this enhancement of mechanical hemostasis, a complementary biochemical hemostatic effect might be expected from the complementary use of prohemostatic drugs such as tranexamic acid.…”

Section: Introductionmentioning

confidence: 99%

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Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial

Sentilhes

Daniel

Darsonval

et al. 2015

BMC Pregnancy Childbirth

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BackgroundPostpartum hemorrhage (PPH) is a major cause of maternal mortality, accounting for one quarter of all maternal deaths worldwide. Estimates of its incidence in the literature vary widely, from 3 % to 15 % of deliveries. Uterotonics after birth are the only intervention that has been shown to be effective in preventing PPH. Tranexamic acid (TXA), an antifibrinolytic agent, has been investigated as a potentially useful complement to uterotonics for prevention because it has been proved to reduce blood loss in elective surgery, bleeding in trauma patients, and menstrual blood loss. Randomized controlled trials for PPH prevention after cesarean (n = 10) and vaginal (n = 2) deliveries show that women who received TXA had significantly less postpartum blood loss without any increase in their rate of severe adverse effects. However, the quality of these trials was poor and they were not designed to test the effect of TXA on the reduction of PPH incidence. Large, adequately powered, multicenter randomized controlled trials are required before the widespread use of TXA to prevent PPH can be recommended.Methods and designA multicenter, double-blind, randomized controlled trial will be performed. It will involve 4000 women in labor for a planned vaginal singleton delivery, at a term ≥ 35 weeks. Treatment (either TXA 1 g or placebo) will be administered intravenously just after birth. Prophylactic oxytocin will be administered to all women. The primary outcome will be the incidence of PPH, defined by blood loss ≥500 mL, measured with a graduated collector bag. This study will have 80 % power to show a 30 % reduction in the incidence of PPH, from 10.0 % to 7.0 %.DiscussionIn addition to prophylactic uterotonic administration, a complementary component of the management of third stage of labor acting on the coagulation process may be useful in preventing PPH. TXA is a promising candidate drug, inexpensive, easy to administer, and simple to add to the routine management of deliveries in hospitals. This large, adequately powered, multicenter, randomized placebo-controlled trial seeks to determine if the risk-benefit ratio favors the routine use of TXA after delivery to prevent PPH.Trial registrationClinicalTrials.gov NCT02302456 (November 17, 2014)

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Section: Methods and Designmentioning

confidence: 99%

Section: Methods and Designmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial

Sentilhes

Daniel

Darsonval

et al. 2015

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…The review by Hofmeyr et al included two randomised controlled trials [33]. The first trial randomised women to receive uterine massage or no massage following delivery of the placenta, after active management of the third stage of labour including use of oxytocin.…”

Section: Methodsmentioning

confidence: 99%

“…For use of uterine massage before and after delivery of the placenta, another trial assigned women to receive oxytocin, uterine massage or both after delivery of the baby but before delivery of the placenta. There was no added benefit for uterine massage plus oxytocin over oxytocin alone with respect to blood loss ≥500ml (RR 1.56, 95% CI 0.44, 5.49) or need for additional use of uterotonic (RR 1.02, 95% CI 0.56, 1.85) [33]. …”

Section: Methodsmentioning

confidence: 99%

Essential childbirth and postnatal interventions for improved maternal and neonatal health

et al. 2014

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Childbirth and the postnatal period, spanning from right after birth to the following several weeks, presents a time in which the number of deaths reported still remain alarmingly high. Worldwide, about 800 women die from pregnancy- or childbirth-related complications daily while almost 75% of neonatal deaths occur within the first seven days of delivery and a vast majority of these occur in the first 24 hours. Unfortunately, this alarming trend of mortality persists, as287,000 women lost their lives to pregnancy and childbirth related causes in 2010. Almost all of these deaths were preventable and occurred in low-resource settings, pointing towards dearth of adequate facilities in these parts of the world. The main objective of this paper is to review the evidence based childbirth and post natal interventions which have a beneficial impact on maternal and newborn outcomes. It is a compilation of existing, new and updated interventions designed to help physicians and policy makers and enable them to reduce the burden of maternal and neonatal morbidities and mortalities. Interventions during the post natal period that were found to be associated with a decrease in maternal and neonatal morbidity and mortality included: advice and support of family planning, support and promotion of early initiation and continued breastfeeding; thermal care or kangaroo mother care for preterm and/or low birth weight babies; hygienic care of umbilical cord and skin following delivery, training health personnel in basic neonatal resuscitation; and postnatal visits. Adequate delivery of these interventions is likely to bring an unprecedented decrease in the number of deaths reported during childbirth.

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