Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage

Salati, Jennifer; Leathersich, Sebastian; Williams, Myfanwy J; Cuthbert, Anna; Tolosa, Jorge E.

doi:10.1002/14651858.cd001808.pub3

Cited by 73 publications

(78 citation statements)

References 83 publications

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“…Another explanation for our nding may be the eschewal of prophylactic administration of oxytocin. This intervention is known to reduce blood loss >500 and >1000 ml after vaginal birth (19).…”

Section: Discussionmentioning

confidence: 99%

Model of Care and Chance of Spontaneous Vaginal Birth: A Prospective, Multicenter Matched-Pair Analysis From North Rhine-Westphalia

Tietjen

Puth

Heep

et al. 2021

Preprint

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BackgroundCompared to standard obstetric care, advantages of midwife-led models of care have been reported; these include a higher vaginal birth rate and less interventions. In Germany, 98.4% of women are giving birth in consultant-led obstetric units. We compared the outcome of birth planned in alongside midwifery units (AMU) in North Rhine-Westphalia (NRW) with a matched group of low-risk women who gave birth in standard obstetric care during the same period of time.MethodsA prospective, controlled, multicenter study was conducted. Six of the seven AMUs in NRW participated. Healthy women with a singleton term cephalic pregnancy booking for birth in AMU were eligible. For each woman in the study group a control was chosen who would have been eligible for birth in AMU but was booking for standard obstetric care at the same hospital at the same time; additionally, matching for parity was performed. Mode of birth was chosen as primary outcome parameter. Secondary endpoints included a composite outcome of abnormal third stage and / or postpartum hemorrhage; higher-order obstetric lacerations; and for the neonate, a composite outcome (5-minute Apgar <7 and / or umbilical cord arterial pH < 7.10 and / or transfer to specialist neonatal care). Statistical analysis was by intention to treat. A non-inferiority analysis was performed for the primary and all secondary endpoints.Results589 case-control pairs were recruited, corresponding to 13.6% of those assumed to be eligible; 198 cases were excluded. Final analysis was performed with 391 case-control pairs. Nulliparous women constituted 56.0% of cases. For the primary endpoint vaginal birth superiority was established for the study group (5.66, 90%-CI 1.26-10.04). Superiority was also confirmed for higher-order obstetric lacerations (2.33, 90%-CI 0.04-4.81). For the composite newborn outcome non-inferiority was established (1.28, 90%-CI 1.33-3.93). Non-inferiority was not present for the composite maternal outcome (-1.56, 90%-CI -5.86-2.75). The epidural anesthesia rate was lower (22.9% vs. 41.1%), and the length of hospital stay was shorter in the study group (p<0.001 for both).Transfer to standard obstetric care occurred in 51.2% of cases, with a strong association between parity and transfer (p<0.001). Request for regional anesthesia was the most common cause for transfer (47.1%). ConclusionOur comparison between care in AMU and standard obstetric care with respect to mode of birth and other outcomes confirmed the superiority of this model of care for low-risk women. Admission and transfer criteria were in place in all participating centers and strictly adhered to.

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Section: Discussionmentioning

confidence: 99%

Model of Care and Chance of Spontaneous Vaginal Birth: A Prospective, Multicenter Matched-Pair Analysis From North Rhine-Westphalia

Tietjen

Puth

Heep

et al. 2021

Preprint

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“…25 Some studies show that oxytocin reduces PPH and the need for therapeutic uterotonic agents by over 40%, and that adding mysoprostol is more effective than using oxytocin alone. 26,27 Once the PPH is recognized, the conservative first line initial therapy is gaining uterine tonicity (up to 40 IU of oxytocin should be administered over 30 minutes), setting up a monitoring system and identifying the cause of bleeding (tone, tissue, trauma, and thrombin). Blood volume and coagulation must be restored, ensuring hemodynamic stability.…”

Section: Discussionmentioning

confidence: 99%

Case study of atonic internal postpartum haemorrhage following severe preeclampsia and caesarean section

Bordo

Grabe

2020

Int J Reprod Contracept Obstet Gynecol

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Postpartum haemorrhage is most often diagnosed by visualizing external vaginal bleeding, however, in some cases the bleeding may be internal, which significantly increases the risk for delayed diagnosis. We present a case report of a puerperal woman with delayed diagnosis of internal postpartum haemorrhage, which is caused by the development of a Couvelair’s uterus after caesarean section, resulting in an acute hysterectomy.

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“…Такие интерлейкины, как 1β (ИЛ-1β) и фактор некроза опухолей α (ФНО-α), довольно часто упоминаются в связи с развитием родовой деятельности [3]. Хорошо известным, но по-прежнему до конца не изученным является пептидный гормон окситоцин, который выполняет в организме различные функции, в основном связанные с родами (с предотвращением послеродовых кровопотерь) и индукцией родов [4,5].…”

Section: Introductionunclassified

Prognostic role of cytokines and oxytocin in the choice of childbirth delivery options for women with diabetes mellitus

Крукиер¹,

Grigor'yants²,

Avrutskaya³

et al. 2019

Ross. vestn. akush.-ginekol.

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акушерства и педиатрии (дир.-д.м.н. А.А. Лебеденко) ФГБОУ ВО «Ростовский государственный медицинский университет» Минздрава России, Ростов-на-Дону, Россия; 2 ФГБНУ «Научно-исследовательский институт акушерства, гинекологии и репродуктологии им. Д.О. Отта» (врио дир.-член-корр. РАН, д.м.н., проф. И.Ю. Коган) Минздрава России, Санкт-Петербург, Россия; 3 ФГБОУ ВО «Ставропольский государственный медицинский университет» (ректор-д.м.н., проф. В.И. Кошель) Минздрава России, Ставрополь, Россия В некоторых исследованиях указано на участие ряда цитокинов в процессе родовой деятельности и продемонстрирована связь между наступлением родов и усилением продукции некоторых цитокинов. Цель исследования-определение значения продукции цитокинов и окситоцина в прогнозировании течения родов и решении вопроса о выборе тактики родоразрешения у беременных с сахарным диабетом 1-го типа. Материал и методы. Обследованы 45 беременных с физиологическим течением беременности и родов (контрольная группа) и 40 беременных с ранее существовавшим сахарным диабетом 1-го типа (основная группа). Наблюдение и обследование беременных проводились в динамике I (12 нед), II (24-28 нед), III (36-38 нед) триместров беременности по программе «Акушерский мониторинг» с 2016 по 2018 г. В сыворотке крови пациенток основной и контрольной групп накануне предполагаемых родов (37-38 нед беременности) определяли уровни интерлейкина-1-β (ИЛ-1β), фактора некроза опухолей альфа (ФНО-α), трансформирующего фактора роста β (ТФР-β) и окситоцина методом иммуноферментного анализа. Результаты. Установлено, что аномалии родовой деятельности развились у 87,5% беременных с сахарным диабетом 1-го типа. Неэффективность родостимуляции у рожениц основной группы при первичной и/или вторичной слабости родовых сил составляла 12,5%. При этом у беременных с сахарным диабетом 1-го типа выявлено повышение уровня ИЛ-1β, ТФР-β, ФНО-α (на 100, 58 и 51% соответственно) накануне родов на фоне снижения уровня окситоцина (на 80%). Заключение. Выявлены сильные корреляции между биохимическими маркерами (ИЛ-1β, ТФР-β, ФНО-α, окситоцином) и сократительной активностью матки (r=0,8) у пациенток основной группы, что позволяет прогнозировать высокую вероятность развития аномалий родовой деятельности и тактику родоразрешения.

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Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage

Abstract: Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage.

Cited by 73 publications

References 83 publications

Model of Care and Chance of Spontaneous Vaginal Birth: A Prospective, Multicenter Matched-Pair Analysis From North Rhine-Westphalia

Model of Care and Chance of Spontaneous Vaginal Birth: A Prospective, Multicenter Matched-Pair Analysis From North Rhine-Westphalia

Case study of atonic internal postpartum haemorrhage following severe preeclampsia and caesarean section

Prognostic role of cytokines and oxytocin in the choice of childbirth delivery options for women with diabetes mellitus

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