Comparative Study of Postpartum Hemorrhage Between Active Management and Expectant Management of the Third Stage of Labor in Buriram Hospital
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Abstract
Purpose: Postpartum hemorrhage is the important cause of maternal deaths, and uterine atony is the most common cause of postpartum hemorrhage. Buriram Hospital has implemented an active management of the third stage of labor but an incidence of postpartum hemorrhage was not 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.
Methods: Pregnant women in Buriram Hospital from 1st April, 2007 to 30th July, 2007.
Results: One hundred and eighty nine pregnant women were selected for 3 groups, 63 of each group. There were no significant differences in characteristic of subjects. Blood loss in the third stage of labor by measurement were 308.05, 266.17, 299.10 ml of subjects in group 1, 2 and control group respectively. Blood loss in the third stage of labor by suggested of subjects in group 1, 2 and control group were 205.36,201.48, 217.48 ml respectively. Duration of the third stage of labor were 5.50, 6.35, 6.14 minutes of subjects in group 1, 2 and control group respectively. The different of hematocrit value between before delivery to 24 hours after delivery were 1.37,3.91,3.77% of subjects in group 1,2 and control group respectively. Incidences of postpartum hemorrhage were 12.6, 7.94, 7.94% of subjects in group 1, 2 and control group respectively.
Conclusions: Blood loss, postpartum hemorrhage, duration of the third stage of labor and complications after delivery 24 hours were not 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
2. งานห้องคลอด กลุ่มงานสูติ-นรีเวชกรรม. รายงานผู้คลอดประจำปี งานห้องคลอด กลุ่มงานสูตินรีเวชกรรม โรงพยาบาลบุรีรัมย์ ปี พ.ศ. 2545-2549. (เอกสารอัดสำเนา)
3. Maughan Karen L, Heim Steven W., Galazka Sim S. Preventing Postpartum Hemorrhage : Managing the Third Stage of Labor. AAFP 2006;73(6):1025-8.
4. World Health Organization. Active management of the third stage. In : Department of Reproductive Health and Research Family and Community health World Health Organization. Integrated Management of Pregnancy and Childbirth Managing complication in pregnancy and childbirth : A guide for midwives and doctors. India : World Health Organization; 2003. : c 73-5
5. Fawcus S. Treatments for primary postpartum haemorrhage. In : The WHO Reproductive Health Library RHL Informing Best Practice in Reproductive Health. No. 8 ed. Oxford : Update Software; 2005.
6. Abalos E. Active versus expectant management in the third stage of labour. In : The WHO Reproductive Health Library RHL Informing Best Practice in Reproductive Health. No. 8 ed. Oxford : Update Software; 2005.
7. Zamora LA. A randomized controlled trial of oxytocin administered at the end of the second stage of labour versus administered at the end of the third stage of labour in the prevention of postpartum hemorrhage. Philipp J Obstet Gynecol 1999 ; 23(4) : 125-33.
8. Prendeville WJ, Harding JE, Elbourne DR, Stirrat GM. The Brital third stage of trial : Active versus Physiological management of third stage of labour. BMJ 1998;297(6659):1295-3.
9. Thilanganathan B, Cutner A, Latimer J, Beard R. Management of third stage of labour in woman at low risk of postpartum hemorrhage. Eur J Obstet Gynecol Reprod Biol 1993;48(1):19-22.
10. Sukprasert M, Choktanasiri W, Ayudhya NI, et al. Increase accuracy of visual estimation of blood loss from education programme. J Med Assoc Thai 2006 ; 89 (Suppl 4) : s54-9.
11. Fenton JJ, Baumeister LM, Fogarty J. Active management of the third stage of labor among American Indian Women. Fam Med 2005;37(6):410-4.
