Postpartum Haemorrhage Clinical Trial
Official title:
Bimanual Uterine Compression to Reduce Blood Loss and Prevent Postpartum Haemorrhage After Vaginal Delivery
the investigators aim to compare bimanual uterine compression immediately after delivery of the placenta for 5 minutes versus no intervention for the prevention of postpartum hemorrhage in Women at high risk for primary atonic postpartum hemorrhage. The primary outcome is postpartum haemorrhage (blood loss of ≥ 500 ml) while the Secondary outcomes include use of additional uterotonics and need for blood transfusion.
the investigators conduct a prospective non- randomized study at Department of Obstetrics and
Gynecology, Benha University Hospital, since April 2014 till May 2016, after approval of the
study protocol by the Local Ethical Committee. A written informed consent is obtained from
eligible women before induction or at early stage of labour.
Women with singleton pregnancies of more than 28 weeks' gestation who are admitted to
hospital and candidates for vaginal delivery are eligible for the study .Gestational age more
than 28 weeks the gestational age is determined based upon the date of the first day of last
normal menstrual period and confirmed by ultrasound scan during the 1st trimester.
The patients (520) are divided into two groups, Group A (260) receive bimanual uterine
compression immediately after delivery of the placenta for 5 minutes while Group B (260)
receive no intervention.
The third stage of labour was managed as usual by clamping and cutting of umbilical cord,
waiting for signs of placental separation and delivering the placenta by controlled cord
traction.
Duration of the 3rd stage of labour is calculated. Patients are kept in labor room under
observation for a period of 1 h.
Measurement of blood loss by a clean plastic lined absorbent drape placed under the woman's
buttocks to collect all the blood lost after delivery of the baby and drainage of the
amniotic fluid. The drape is changed as many times as needed. The woman stays on the drape or
asked to wear a pad over the next 60 minutes. In the case of severe haemorrhage, the
investigators follow the usual guidelines for management of postpartum haemorrhage, and the
supplemental treatment registered. All drapes and pads are weighed on an electronic scale and
the known dry weight of the linen is subtracted. As 1 ml of blood weighs close to 1 g, the
balance in grams is assumed to be the total blood loss in ml.
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