Uterine Massage to Reduce Blood Loss Before Delivery of the Placenta in Caesarean Section: A Retrospective Cohort Study

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.

Effectiveness of Intermittent Uterine Massage in Reducing Blood Loss During Vaginal Delivery: A Comparative Study

“…In a retrospective cohort study by Zhang et women who had high risk for PPH compared to controlled cord traction method during CS. 16 Though there was no significant difference in intractable PPH and incidence of PPH but still they concluded that uterine massage contributed to decreased blood loss during CS in high risk patients for PPH.…”

The value of the combined MR imaging features and clinical factors Nomogram model in predicting intractable postpartum hemorrhage due to placenta accreta

“…Research has shown that multiple cesarean sections may increase the risk of IPH. [12,13] This is because cesarean section can result in uterine scar formation, and the number and repetition of scars may weaken the uterine muscle layer, thereby increasing the risk of postpartum bleeding. Multiple cesarean sections may further diminish the uterine contractile ability, leading to ineffective contractions and inadequate hemostasis, thereby increasing the incidence of IPH.…”