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A New Maneuver for Prevention of Postpartum Haemorrhage

The Journal of Obstetrics and Gynecology of India volume 65, pages 241–245 (2015)Cite this article

Abstract

Background

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. Many methods have been developed to decrease its rate. The aim of this study was to evaluate the applicability of a new non-pharmacologic maneuver in decreasing its rate.

Methods

This case series study was conducted in one center in Cairo, Egypt, from January-2010 to June-2013. 400 pregnant women, aged 18 years or more and candidate for normal labor, were enrolled to this study. High risk subjects for PPH were excluded. After placental delivery, the new maneuver was done by sustained traction of the anterior and posterior lips of the cervix by two ovum forceps for duration of 90 s. The amount of blood loss was estimated by standardized visual estimation after removal of the forceps. All subjects were followed up for 6 h.

Results

The rate of PPH, defined as more than 500 ml, was eight cases (2 %) with 95 % CI (0.63–3.37 %). The rate of PPH was not affected by parity, gestational age, episiotomy, or the presence of tears. PPH is more in cases with anemia (p 0.032). It occurred in all cases with uterine atony (p < 0.001). The range of estimated blood loss was 550–600 ml in cases with PPH and 150–450 ml in cases without PPH. Severe PPH more than 1,000 ml did not occur.

Conclusion

This pilot study introduced a novel maneuver that can be helpful in decreasing the rate of PPH and reducing the amount of postpartum blood loss. Further RCT is recommended to investigate it.

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Acknowledgments

We would like to acknowledge Dr. Emad Roushdy [ClinAmygate] for his efforts in statistical analysis and writing of this manuscript.

Compliance with ethical requirements and Conflict of interest

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study. Amr Hamdy declares that he has no conflict of interest.

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  1. Department of Gynecology and Obstetrics, MOH, Building 3, 287 St., New Maadi, Cairo, Egypt

    Amr Hamdy

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  1. Amr Hamdy
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Correspondence to Amr Hamdy.

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Hamdy, A. A New Maneuver for Prevention of Postpartum Haemorrhage. J Obstet Gynecol India 65, 241–245 (2015). https://doi.org/10.1007/s13224-014-0592-6

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  • DOI: https://doi.org/10.1007/s13224-014-0592-6

Keywords

  • Postpartum hemorrhage
  • New maneuver
  • Sustained cervical traction
  • Uterine atony
  • Maternal mortality