Timing of prophylactic uterotonics for the third stage of labour after vaginal birth

Soltani, Hora; Hutchon, David; Poulose, T

doi:10.1002/14651858.cd006173.pub2

Cited by 66 publications

(47 citation statements)

References 12 publications

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“…Our study noted a statistically significant fall in Hb % in the control group as compared to the study group in concordance with a similar study [11]. Additionally, there was a statistically significant reduction in blood loss in the post-partum period.…”

Section: Discussionsupporting

confidence: 92%

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Roy

Sujatha

Bhandiwad

et al. 2016

J Obstet Gynecol India

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Introduction Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. Objectives To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. Methodology Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was 123 placed over a blood drape-a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given preweighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery. Results The total number of patients studied was 100-equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group. Conclusion Tranexamic acid injection, an antifibrinolytic agent when given prophylactically after the delivery of the baby, by intravenous route appears to reduce the blood loss and maternal morbidity during normal labour effectively.

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Section: Discussionsupporting

confidence: 92%

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Roy

Sujatha

Bhandiwad

et al. 2016

J Obstet Gynecol India

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“…Earlier studies found no consistent difference between oxytocin administered with delivery of the anterior shoulder or with delivery of the placenta. 35 Every facility should have a departmental protocol for oxytocin use in the immediate postpartum period. 36 The World Health Organization, the College, the American Academy of Family Physicians, and AWHONN recommend oxytocin administration after all births.…”

Section: Active Management Of Third Stage Of Labormentioning

confidence: 99%

National Partnership for Maternal Safety

Main

Goffman

Scavone

et al. 2015

Anesthesia &Amp; Analgesia

316

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Hemorrhage is the most frequent cause of severe maternal morbidity and preventable maternal mortality and therefore is an ideal topic for the initial national maternity patient safety bundle. These safety bundles outline critical clinical practices that should be implemented in every maternity unit. They are developed by multidisciplinary work groups of the National Partnership for Maternal Safety under the guidance of the Council on Patient Safety in Women's Health Care. The safety bundle is organized into four domains: Readiness, Recognition and Prevention, Response, and Reporting and System Learning. Although the bundle components may be adapted to meet the resources available in individual facilities, standardization within an institution is strongly encouraged. References contain sample resources and "Potential Best Practices" to assist with implementation.

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“…As several authors [11] have reported that it is seen that the time to use oxytocin in the 3 rd stage of labor is not important in terms of postpartum hemorrhage.…”

Section: Discussionmentioning

confidence: 95%