Cold Pack Compression to the Lower Abdomen after Childbirth to Reduce Blood Loss in Women Undergoing Vaginal Delivery: A randomized controlled trial

Abstract

Objectives: To determine the efficacy of cold pack compression to the lower abdomen after childbirth until 2 hours postpartum to reduce blood loss.
Materials and Methods: Sixty singleton pregnant women who underwent normal delivery at Khon Kaen Hospital between February and June 2020 were randomly allocated to two groups, one receiving cold pack compression to the lower abdomen after childbirth until 2 hours postpartum (n = 30) versus standard vaginal delivery (n = 30). The respective amount of blood loss in both groups was measured from after childbirth until 2 hours postpartum by calculating the total weight of blood from the blood collecting bag and diapers. Additional blood transfusion, adverse events from the cold pack, and the after-pain score were recorded.
Results: Baseline characteristics between groups were comparable. Mean blood loss in the cold pack compression group was significantly lower than the standard vaginal delivery group (183.87 ± 76.52 vs. 271.36 ± 103.80 ml, mean difference was -87.50, 95% confidence interval -134.62 to -40.37, p < 0.001). None of the participants in either group experienced postpartum hemorrhage or required blood transfusion. None of the participants in the cold pack compression group experienced any adverse events. There was no statistical difference in the after-pain score between groups.
Conclusion: Cold pack compression to the lower abdomen after childbirth until 2 hours postpartum could significantly reduce blood loss compared with standard vaginal delivery without serious adverse events.