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The effect of uterine massage after vaginal delivery on the duration of placental delivery and amount of postpartum hemorrhage

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to investigate the effects of uterine massage performed before placental delivery on the third stage of labor and postpartum hemorrhage after vaginal delivery.

Materials and methods

The study was designed as a prospective randomized controlled study. Between June 2018 and June 2019, 242 women who gave birth in Istanbul Kanuni Sultan Suleyman Training and Research Hospital were included in the study. The women were divided into two groups; group 1 received uterine massage after vaginal delivery before placental delivery (n: 128) and group 2 did not receive massage (n: 114). Demographic characteristics, delivery times of the baby and placenta, duration of uterine massage, amount of postpartum hemorrhage and postpartum hemoglobin values of both groups were recorded.

Results

Baseline characteristics were similar in both groups. Placental output time after delivery was 8.3 ± 4.2 min in group 1 and 13.5 ± 6.3 min in group 2. The third stage of labor was significantly shorter in group 1 (p = 0.012). The amount of blood loss of 500 mL or more after delivery was higher in group 2 but not statistically different (p > 0.05). Hemoglobin value measured within 12–24 h after delivery was significantly lower in group 2 (hemoglobin < 8 g/dL after 12–24 h p = 0.003; hemoglobin < 10 g/dL after 12–24 h p = 0.001). Delta hb value was also significantly lower in group 2 (p = 0.03). With this result, it was determined that bleeding intense enough to require transfusion was more common in group 2.

Conclusion

In patients delivering vaginally, uterine massage before placental delivery shortens the placental delivery time and reduces postpartum hemorrhage. In addition to oxytocin and controlled cord traction to reduce postpartum blood loss, uterine massage should be routinely used in the active management of the third stage of labor.

Clinical trials number: NCT03858569.

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Data availability

The authors have the data availability statement.

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Funding

The authors have not disclosed any funding.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Acıbadem University Atakent Hospital, Istanbul, Turkey

    Pinar Kadirogullari

  2. Department of Obstetrics and Gynecology, Health Sciences University, Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey

    Berna Aslan Cetin, Mustafa Goksu & Hale Cetin Arslan

  3. Department of Obstetrics and Gynecology, Istinye University Liv Hospital Vadi Istanbul, Istanbul, Turkey

    Kerem Doga Seckin

Authors
  1. Pinar Kadirogullari
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  2. Berna Aslan Cetin
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  3. Mustafa Goksu
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  4. Hale Cetin Arslan
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  5. Kerem Doga Seckin
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Contributions

All authors contributed to the study conception and design. PK: project development/manuscript writing/data collection; BAC: statistical analysis/project development; MG: statistical analysis/manuscript editing; HCA: data collection; KDS: writing editing/statistical analysis. The first draft of the manuscript was written by PK and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Pinar Kadirogullari.

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Kadirogullari, P., Aslan Cetin, B., Goksu, M. et al. The effect of uterine massage after vaginal delivery on the duration of placental delivery and amount of postpartum hemorrhage. Arch Gynecol Obstet (2023). https://doi.org/10.1007/s00404-023-07211-5

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