Active Management in the Prevention of Postpartum Hemorrhage
Postpartum hemorrhage (PPH) is a risk factor for all pregnant women who have progressed beyond 20 weeks’ gestation. Although maternal mortality rates have decreased drastically in developed countries, postpartum hemorrhage remainsthe leading cause of maternal death elsewhere. It is defined as blood loss of more than 500 ml following vaginal delivery, or more than 1000 ml following cesarean delivery. (1) A loss of these amounts within 24 hours of delivery is termed early or primary PPH; whereas such losses are termed late or secondary PPH if they occur 24 hours after delivery. It should be noted that estimating blood loss at time of delivery is generally inaccurate. Studies have suggested that caregivers consistently underestimate the amount of actual blood loss. Some mightsuggest that PPH should be diagnosed with any amount of blood loss that threatens the hemodynamic stability of the woman, keeping in mind that not all patients have the same coping capacity
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Postpartum hemorrhage (PPH), an extensive threat to maternal fatalities. Defined as blood loss of more than 500 ml following vaginal delivery, or more than 1000 ml following caesarean delivery in the first 24 hours of birth. To test the hypothesis that the use of active management of third stage of labor (AMTSL) - a combination of, administration of uterotonics, early cord clamping, and controlled cord traction used to speed up delivery of the placenta with the aim of reducing blood loss for lowering the rates of primary PPH - compared to expectant management. This hypothesis was proven through different experiments using descriptive cross-sectional study, descriptive statistical analysis, and lastly cohort analysis to be able to achieve an unbiased settlement, by using population studies. Active management of the third stage reduced the risk of hemorrhage greater than 1000ml at the time of birth, in a population of women at mixed risk of excessive bleeding, but adverse effects were identified
