The Outcome of Lower Uterine Segment Compression for 8 minutes at Nakhonnayok Hospital in Normal Vaginal Delivery to Prevent Early Postpartum Hemorrhage

Abstract

The objective of this experimental research was to determine the outcome and amount of blood loss between the lower uterine segment compression for 8 minutes method and the conventional treatment in normal vaginal delivery. The present study was done at Department of Obstetrics and Gynecology in Nakhonnayok Hospital between June and October 2021. All subjects had a singleton pregnancy with a gestational age between 37-42 week and no past medical history. Cases with polyhydramnios or treated with magnesium sulfate or complications comprising uterine inversion or rupture, hematoma or severe laceration of birth canal, retained placenta were excluded. The purposive sampling was devided into two groups, the experimental group and the control group. Mothers in both experimental and control group were treated with the same method, oxytocin administration, clamping and cutting umbilical cords within three minutes after birth of the newborns, and placental delivery was done by controlled cord traction together with uterine massage at the fundus, through the abdominal wall immediately, In addition, in the experimental group, the subjects were assisted by lower uterine segment compression for 8 minutes. The amount of blood loss in both control and experimental group were collected within a 2 hour postpartum period. The results revealed that the experimental group had a significantly lower mean of blood loss in the third stage and the fourth stage of labor than the control group (256.93 ± 95.63 ml. vs 216.07 ± 76.00 ml., P = .002 in the third stage and 63.67 ± 15.74 ml. vs 57.50 ± 12.41 ml., P = .004 in the fourth stage). It was found that lower uterine segment compression could reduce significantly the incidence rate of early postpartum hemorrhage (5.7% vs 1.1%, P = .006) There finding suggested that the lower uterine segment compression immediately after placental delivery for 8 minutes could reduce the rate of early postpartum hemorrhage and amount of blood loss after normal vaginal delivery. The efficacy of this technique was over the conventional method. Beside, Lower uterine segment compression was easy and safe. Neither anesthesia nor extra-expense was needed