Massage to prevent postpartum bleeding
This Cochrane review concludes, “Uterine massage after delivery of the placenta is advised to prevent postpartum hemorrhage.”
First, the details.
- After searching the literature, 1 study of 200 women randomly assigned to uterine massage or no massage after active management of the third stage of labor was reviewed.
- The third stage of labor includes the time from delivery of the newborn through delivery of the placenta.
And, the results.
- There were few cases of women with blood loss greater than 500 mL (a little less than 2 pints).
- There were no cases of retained placenta in either group.
- The average blood loss was less with uterine massage than no massage at 30 minutes (average difference -42 vs -75 mL, respectively) and at 60 minutes after enrolment (-77 vs -36 mL).
- The need for additional uterotonics (drugs to prevent or treat postpartum hemorrhage) was reduced with uterine massage.
- 2 blood transfusions were given in the no massage group.
The bottom line?
The reviewers concluded that the results of this study support the 2004 joint statement of the International Confederation of Midwives and the International Federation of Gynaecologists and Obstetricians on the management of the third stage of labor. Namely, that uterine massage after delivery of the placenta is advised to prevent postpartum bleeding.
However, 1 study isn’t much to hang you hat on. So, bigger, better studies are needed.
7/26/08 18:22 JR
