Less blood loss after actively versus expectantly managed labor
MedWire News: Women who are actively managed during the third stage of labor experience less blood loss than those who are expectantly managed, show results of a Swedish study.
"Blood loss up to 1000 ml may be well tolerated and considered normal in healthy women," explain Elisabeth Jangsten (University of Gothenburg) and colleagues, who found that 10.0 percent of actively managed women in their study lost more than this amount, compared with 16.8 percent of expectantly managed women.
The cohort included 1,802 women randomly assigned to receive either active (n = 903) or expectant (n = 899) management.
Both approaches included immediate clamping of the cord after birth and uterine massage after placenta delivery, while in active management women were given 2 ml oxytocin after delivery followed by controlled cord traction, versus 2 ml saline, and encouragement to push the placenta out.
Actively managed women also had significantly lower mean blood loss than expectantly managed women, at 535 ml versus 680 ml.
Hemoglobin levels were also higher in actively managed women the day after delivery compared with expectantly managed women, at 118 versus 115 g/dl.
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By Sarah Guy