Childbirth Clinical Trial
Official title:
A Comparison of Active and Expectant Management of the Third Stage of Labor
The purpose with this study was to compare blood loss and women's experience of afterpains
during the third stage when handled with active or expectant management of the third stage
of labour.
Hypothesis 1. To detect a 5% difference (15% vs 10%) in blood loss >1000 mL between the two
groups with 80% power (α=0.05), at least 726 subjects were required in each group.
Hypothesis 2. Afterpains are more pronounced in active compared to expectant management
during the third stage of labour
Management of the third stage of labour has been focus for investigation during decades and
active management of the third stage of labour (AMTSL)has been recommended in all women
giving birth vaginally at hospitals. In Sweden the recommendation has been to give an
injection of oxytocin immediately after birth of the neonate but not the entire AMTSL
procedure.
Women in labour were asked to participate voluntarily when entering the hospital and after
acceptance they were randomised to either active or expectant management of the third stage
of labour(EMTSL).
AMTSL included:
- Early cord clamping
- 10 UI oxytocin i.v
- controlled cord traction
- uterine massage after placenta expulsion
EMTSL included:
- early cord clamping
- 2 mL saline solution i.v
- wait for signs of placenta detachment
- encourage the women to push out placenta by her own effort
- uterine massage after placenta expulsion
All blood was measured by weighing bed pads and sanitary towels up to two hours postpartum
Assessment of afterpains was performed by a Visual Analogue Scale (VAS) and the Pain-o-meter
(POM-WDS) two hours after the delivery of placenta, and the day after childbirth.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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