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Uterine Massage to Reduce Blood Loss Before Delivery of the Placenta in Caesarean Section: A Retrospective Cohort StudyAcknowledgements and Funding: This work was supported by the Supported by Health commission of Zhejiang province (2018KY714).
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.
Received: 20 December 2020
Accepted after revision: 28 January 2021
10 March 2021 (online)
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- 1 Grobman WA, Bailit JL, Rice MM. et al. Frequency of and factors associated with severe maternal morbidity. Obstet Gynecol 2014; 123: 804
- 2 Kramer MS, Berg C, Abenhaim H. et al. Incidence, risk factors, and temporal trends in severe postpartum hemorrhage. Am J Obstet Gynecol 2013; 209: 449. e441-449.e447
- 3 Anderson JM, Etches D. Prevention and management of postpartum hemorrhage. Am Fam Physician 2007; 75: 875-882
- 4 Khan KS, Wojdyla D, Say L. et al. WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367: 1066-1074
- 5 WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization; 2012
- 6 Guidelines for oxytocin administration after birth: AWHONN practice brief number 2. Nurs Womens Health 2015; 19: 99-101
- 7 Evensen A, Anderson JM, Fontaine P. Postpartum hemorrhage: prevention and treatment. Am Fam Physician 2017; 95: 442-449
- 8 Prevention and management of postpartum haemorrhage. BJOG 2016; 124: e106-e149
- 9 ACOG Committee on Practice Bulletins-Obstetrics Practice bulletin no. 183: Postpartum hemorrhage. Obstet Gynecol 2017; 130: e168-e181
- 10 Hofmeyr GJ, Abdel-Aleem H, Abdel-Aleem MA. Uterine massage for preventing postpartum haemorrhage. Cochrane Database Syst Rev 2013; CD006431
- 11 Abdel-Aleem H, Hofmeyr G, Shokry M. et al. Uterine massage and postpartum blood loss. Int J Gynecol Obstet 2006; 93: 238-239
- 12 Abdel-Aleem H, Singata M, Abdel-Aleem M. et al. Uterine massage to reduce postpartum hemorrhage after vaginal delivery. Int J Gynecol Obstet 2010; 111: 32-36
- 13 Chen M, Chang Q, Duan T. et al. Uterine massage to reduce blood loss after vaginal delivery: a randomized controlled trial. Obstet Gynecol 2013; 122: 290-295
- 14 Althabe F, Alemán A, Tomasso G. et al. A pilot randomized controlled trial of controlled cord traction to reduce postpartum blood loss. Int J Gynecol Obstet 2009; 107: 4-7