Comparative Study of Postpartum Blood Loss and Postpartum hemorrhage Between Active Management and Expectant Management of the Third Stage of Labor in Sisaket Hospital
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Abstract
Purpose: Postpartum hemorrhage has been defined as the loss of 500 mL or more of blood after completetion of the third stage of labor. Postpartum hemorrhage is the important cause of maternal deaths, and uterine atony is the most common cause of postpartum hemorrhage. Sisaket Hospital has implemented an active management of the third stage of labor and an incidence of postpartum hemorrhage was decrease.
Objective: To assess the effectiveness of active management versus expectant management on blood loss, postpartum hemorrhage, duration of the third stage of labor and complications after delivery 24 hours.
Research design: Experimental research : Clinical trial.
Samples: Pregnant wemen in Sisaket Hospital from 1st October, 2009 to 31th March, 2010.
Results: 130 pregnant wemen were randomized sampling into two groups, 65 of each group. There were no significant differences in characteristic of subjects in age, gestational age, mean diastolic blood pressure except the mean systolic blood pressure and placental weight which revealed the significant differences. Duration of the third stage of labor were 5.72, 11.45 minutes in group 1, 2 respectively. Blood loss in the third stage of labor by clinical measurement were 317.60 1 377.54 ml in group 1, 2 respectively. While the blood loss in the third stage of labor by professional estimation were 224.00, 232.00 ml in group 1, 2 respectively. The different of hematocrit value between before delivery to 24 hours after delivery were 1.42 %, 1.44% in group 1, 2 respectively. While the incidences of postpartum hemorrhage were 1.97% , 0.21 % in each group respectively.
Conclusions: Duration of the third stage of labor ,blood loss in the third stage of labor by measurement were significant differences but incidences of postpartum hemorrhage were no significantly. We should improve active management of the third stage of labor procedure by do it by specialist.
Key words: Active management, expectant management, third stage of labor, postpartum hemorrhage
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References
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