Reducing postpartum hemorrhage in Vietnam: Assessing the effectiveness of active management of third‐stage labor

Tsu, Vivien; Tran, Thang; Nguyen, Yen H.; Luu, Huong

doi:10.1111/j.1447-0756.2006.00436.x

Cited by 23 publications

(29 citation statements)

References 17 publications

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“…In a meta-analysis of 17 studies, while the rate of post-partum haemorrhage varied between 4% and 51% without uterotonic treatment, it was shown that the rate of post-partum haemorrhage regressed to the following values with prophylactic oxytocin infusion, misoprostol treatment and ergometrine treatment, respectively: 0-32%, 1-45% and 0-37%. In the same study, the blood loss occurring with the administration of prophylactic uterotonic treatment was compared [9,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. It was found that this was reduced by an average of 151-499 mL in the patients administered with oxytocin, 155-433 mL in the patients administered with misoprostol and 149-476 mL in the patients administered with ergometrine.…”

Section: Discussionmentioning

confidence: 99%

The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post‐partum Haemorrhage

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et al. 2015

Basic Clin Pharma Tox

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We aimed to show to patients the benefit of post-partum haemorrhage prophylaxis treatment and the effectiveness as a uterotonic agent of the combined use of methylergonovine and oxytocin infusion in the prevention of haemorrhage during and after Caesarean section, by comparison with a control group which received oxytocin infusion only. Two groups of patients undergoing Caesarean section at the same clinic were included in the study. A combination of methylergonovine and oxytocin was administered to the first group during the intra-operative and post-operative periods. The second group did not receive methylergonovine and was administered only with oxytocin infusion in the intra-operative and post-operative periods. Pre-operative and post-operative haemogram readings were taken for all patients in each of the groups for comparison. No difference was found between the two groups with regard to mean ages and pre-operative haemogram values. The decrease in post-operative haemoglobin values for the group administered with methylergonovine maleate and oxytocin was found to be significantly greater than for the group administered with oxytocin only. Results indicated that prophylactic methylergonovine treatment was clearly successful for the patients and no adverse side effects were found. The routine use of methylergonovine and oxytocin infusion in combination during the intra-operative period of Caesarean section reduced the level of post-partum haemorrhage considerably. We believe that this procedure will also reduce the risk of uterine atony, but clearly, prospective studies will be necessary in future to confirm this assumption.In recent years, there has been a marked increase in the number of Caesarean sections carried out. This can be attributed largely to the rise in the rate of primary elective Caesarean section. In turn, this has led to a higher frequency of placenta previa, uterine atony and post-partum haemorrhage.The increased prevalence of post-partum haemorrhage across the world is of particular concern as it is widely recognized as a major contributor to maternal mortality. Studies have estimated that post-partum haemorrhage might account for as much as 30% of maternal mortality and its incidence all over the world ranged from 2 to 11% of all childbirths [1,2]. The frequency of post-partum haemorrhage was found to be higher in underdeveloped regions such as Africa, Asia and Latin America [3]. The currently accepted definition is to consider post-partum haemorrhage as blood loss of more than 500 mL whatever the type of delivery and severity as blood loss beyond 1000 mL [4]. The American College of Obstetricians and Gynaecologists adjudged that a decrease in haematocrit at a rate of 10% or more constituted post-partum haemorrhage [5].Although haemoglobin and haematocrit levels are valuable diagnostic tools in identifying haemorrhage, they can be misleading in the determination of acute bleeding. Therefore, follow-up of a patient's vital signs, together with checks of haemoglobin and haematocrit...

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Section: Discussionmentioning

confidence: 99%

The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post‐partum Haemorrhage

Şentürk

Kağıtçı

Balık

et al. 2015

Basic Clin Pharma Tox

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“…Secara statistik IMD mempunyai hubungan yang bermakna dengan jumlah perdarahan pasca salin, namun hasil penelitian ini menunjukkan bahwa semua perdarahan yang terjadi kurang dari 200 cc, baik pada ibu yang menjalani IMD maupun pada ibu yang tidak menjalani IMD. 9,18,19,20 Adanya isapan bayi pada puting susu ibu menyebabkan oksitosin akan keluar lebih banyak. Hal ini menguntungkan karena otot-otot polos rahim akan terus berkontraksi.…”

Section: Hasil Dan Pembahasanunclassified

“…Rata-rata perbedaan jumlah perdarahan pada kedua kelompok adalah -38,1 cc. Perbedaan ini secara statistik signifikan dengan p <0,05 (p = 0,000), 95% CI = 54, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]7. Variabel eksternal, baik usia, paritas atau pendidikan ibu, tidak memiliki hubungan yang signifikan dengan jumlah perdarahan postpartum dengan p> 0,05.…”

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Pengaruh Inisiasi Menyusu Dini Terhadap Jumlah Perdarahan Pasca Persalinan

2014

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Background: Mortality and morbidity among women during pregnancy and labour are a major problem in poor and developing countries including Indonesia. The prevalence of postpartum hemorrhage is between 2-11% out of all childbirth. Postpartum hemorrhage is the main cause of maternal mortality (28%). Maternal mortality mainly occurs within the first 4 hours after childbirth. Uterus contraction after childbirth greatly minimizes the risk of hemorrhage. Early breastfeeding initiation stimulates the back of hypofiche gland to produce oxytoxin that ignites womb muscle contraction so that the risk for the prevalence of postpartum hemorrhage can be minimized. Objective: To identify the impact of early breastfeeding initiation to the amount of postpartum hemorrhage. Method: The study was observational with prospective cohort design. Subject of the study were normal partum mothers at Sleman Hospital taken using non probability with consecutive sampling technique (62 samples). Data analysis used univariate with frequency distribution and percentage, bivariate with independent t-test and multivariate with linear regression. Result and Discussion: Average amount of blood in postpartum mothers that practised early breastfeeding initiation (EBI) was lower than those without EBI. The average amount of hemorrhage in mothers that practice EBI was 77,26 + 33,6 cc, and in mothers that did not practiced EB was 115,4 +31,0 cc. Average difference in the amount of hemorrhage in the two groups was -38,1 cc. This difference was statistically significant with p<0,05 (p=0,000), 95%CI=-54,6--21,7. External variables, either age, parity or education of mothers, had no significant association with the amount of postpartum hemorrhage (p>0,05). Conclusion: EBI affected the amount of postpartum hemorrhage. Average amount of postpartum hemorrhage in mothers that practiced practised EBI was 38,1 cc less than in those that did not practise EBI.Keywords: postpartum, early breastfeeding initiation, skin to skin contact ABSTRAK Latar Belakang: Mortalitas dan morbiditas pada wanita selama kehamilan dan persalinan adalah masalah besar di negara-negara miskin dan berkembang termasuk Indonesia. Prevalensi perdarahan postpartum adalah 2-11% dari semua persalinan. Perdarahan postpartum merupakan penyebab utama kematian ibu (28%). Kematian ibu terutama terjadi dalam 4 jam pertama setelah melahirkan. Kontraksi rahim setelah melahirkan sangat meminimalkan risiko perdarahan. Inisiasi menyusui dini merangsang bagian belakang kelenjar hypofiche untuk menghasilkan oxytoxin yang memicu kontraksi otot rahim sehingga resiko untuk prevalensi perdarahan postpartum dapat diminimalkan. Tujuan: Untuk mengidentifikasi dampak dari inisiasi menyusui dini terhadap jumlah perdarahan postpartum. Metode: Jenis penelitian ini adalah observasional dengan rancangan kohort prospektif. Subyek penelitian adalah ibu yang melahirkan normal di Rumah Sakit Sleman diambil menggunakan non probability dengan teknik pengambilan sampel berturut-turut (62 sampel). Analisis data yang digu...

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Reducing post-partum hemorrhage in Vietnam: Assessing the effectiveness of active management of third-stage labor Dear Editor, We were interested in the paper by Tsu et al 1 and support the use of oxytocin to manage third-stage labor (AMTSL) in a low-resource country when carried out by skilled attendants.We also agree that misoprostol is the proven efficacious drug for AMTSL in situations in which most women deliver without a skilled attendant especially in the developing countries. Misoprostol has a long shelflife, is stable, easy to administer (oral/rectal) and is very economical.

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mentioning

confidence: 98%

Reducing post‐partum hemorrhage in Vietnam: Assessing the effectiveness of active management of third‐stage labor

Mahajan¹,

Mahajan²,

Soni³

2007

J of Obstet and Gynaecol

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Reducing post-partum hemorrhage in Vietnam: Assessing the effectiveness of active management of third-stage labor Dear Editor, We were interested in the paper by Tsu et al. 1 and support the use of oxytocin to manage third-stage labor (AMTSL) in a low-resource country when carried out by skilled attendants.We also agree that misoprostol is the proven efficacious drug for AMTSL in situations in which most women deliver without a skilled attendant especially in the developing countries. Misoprostol has a long shelflife, is stable, easy to administer (oral/rectal) and is very economical. In developing countries health resources are meager and the best health care does not reach the underprivileged rural masses. Misoprostol is useful in situations where vaginal deliveries take place away from hospitals or medical facilities and are supervised only by birth attendants (who may not be qualified to administer parenteral oxytocics) 2,3 or, most often, not supervised at all. Re-use of needles for parenteral administration is common practice, thus posing a major risk for spread of blood-borne infections such as hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) infection. Further, there is lack of availability of safe blood transfusion services and prior knowledge of blood pressure often is not available. 2 The use of misoprostol is certainly vital in developing countries to prevent post-partum hemorrhage.The authors mention quantifying post-partum blood loss using standard containers, in which the contents of the tray were emptied into a smaller plastic cylindrical basin. But there are difficulties and potential discrepancies associated with measuring blood loss after childbirth: blood may be mixed with maternal liquor, urine, and cleansing solutions used by providers. When collected, blood may be soaked on swabs, gauze, towels, or linen. It may splash on surfaces or drain from the placenta or cord and be difficult to collect. 4 We therefore seek their clarification. References 1. Tsu VD, Mai TT, Nguyen YH, Luu HT. Reducing post-partum hemorrhage in Vietnam: Assessing the effectiveness of active management of third-stage labor. J Obstet Gynaecol Res 2006; 32: 489-496. 2. O'Brien P, El-Refaey H. The management of the third stage of labor using misoprostol in low risk women. Contemp Rev Obstet Gynecol 1997; 9: 27-32. 3. Surbek DV, Fehr PM, Hosli I, Holzgreve W. Oral misoprostol for third stage of labor: A randomized placebo-controlled trial.

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Reducing postpartum hemorrhage in Vietnam: Assessing the effectiveness of active management of third‐stage labor

Abstract: This study supports the value of AMTSL in reducing the incidence of PPH, shortening the third stage of labor, and reducing the need for additional treatments.

Cited by 23 publications

References 17 publications

The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post‐partum Haemorrhage

The Effect of the Combined Use of Methylergonovine and Oxytocin during Caesarean Section in the Prevention of Post‐partum Haemorrhage

Pengaruh Inisiasi Menyusu Dini Terhadap Jumlah Perdarahan Pasca Persalinan

Reducing post‐partum hemorrhage in Vietnam: Assessing the effectiveness of active management of third‐stage labor

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