COMPARATIVE STUDY FOR DIFFERENT PREVENTIVE METHODS FOR POSTPARTUM HEMORRHAGE (PPH)

Authors

  • M ABBASI Department of Obstetrics and Gynecology, Civil Hospital LUMHS Jamshoro/ Hyderabad, Pakistan
  • ES SIDDIQUI Department of Obstetrics and Gynecology, Civil Hospital LUMHS Jamshoro/ Hyderabad, Pakistan
  • S GHAFFAR Department of Obstetrics and Gynecology, Civil Hospital LUMHS Jamshoro/ Hyderabad, Pakistan
  • DR HEMLATA Department of Obstetrics and Gynecology, Muhammad Medical College Ibn e Sina University Mirpurkhas Sindh, Pakistan
  • N JABEEN . Nadia Jabeen Department of Gynecology, Rawal Institute of Health Sciences Islamabad, Pakistan
  • W QARSHI Department Of Physiology, Abwa Medical College Faisalabad, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.293

Keywords:

preventive methods, a comparative study, atheterization, ANOVA

Abstract

Different preventive methods have been used to reduce the incidence of PPH, but their efficacy, safety, and cost-effectiveness have not been well established. We conducted a comparative study to evaluate the effectiveness, side effects, and cost of different preventive methods for PPH. 120 patients at LUMHS from 2021 to 2022 were randomly assigned to receive one of four preventive methods: oxytocin, misoprostol, tranexamic acid, or prophylactic balloon catheterization. Data on the incidence of PPH, mean blood loss, need for additional interventions, and adverse events were collected and analyzed using logistic regression and ANOVA. The incidence of PPH was significantly lower in the tranexamic acid group (4%) and the prophylactic balloon catheterization group (6%) compared to the oxytocin group (16%) and the misoprostol group (14%). The mean blood loss was also significantly lower in the tranexamic acid and the prophylactic balloon catheterization groups than in the oxytocin and misoprostol groups. The need for additional interventions and adverse events were also significantly lower in the tranexamic acid and prophylactic balloon catheterization groups. Our study provides evidence to support tranexamic acid and prophylactic balloon catheterization as effective and safe preventive methods for PPH, with minimal side effects and low cost. Oxytocin remains a viable option for preventing PPH, but misoprostol should be used cautiously due to its higher incidence of adverse events.

Downloads

Download data is not yet available.

References

World Health Organization. WHO Recommendations for the Prevention and Treatment of Postpartum Haemorrhage. Geneva: World Health Organization; 2012.

Gizzo S, Noventa M, Saccardi C, et al. Pharmacological approaches to postpartum haemorrhage: from uterotonics to new drug classes. Expert Opin Pharmacother. 2014;15(16):2303-2311.

Dildy GA 3rd. Postpartum hemorrhage: new management options. Clin Obstet Gynecol. 2002;45(2):330-344.

Sentilhes L, Gromez A, Clavier E, Resch B, Verspyck E, Marpeau L. Prediction of postpartum haemorrhage using the quantitative estimation of blood loss. Eur J Obstet Gynecol Reprod Biol. 2010;151(2):163-167.

Doumouchtsis SK, Arulkumaran S. Are all forms of postpartum haemorrhage preventable with appropriate prophylaxis? Br J Haematol. 2009;147(6):646-649.

Strand RT, Da Silva F, Jangsten E, Bergström S. Postpartum hemorrhage: a prospective, comparative study in Angola using a new disposable device for oxytocin administration. Acta Obstet Gynecol Scand. 2005 Mar;84(3):260-5. doi: 10.1111/j.0001-6349.2005.00579.x. PMID: 15715534.

Leduc D, Senikas V, Lalonde AB, Ballerman C, Biringer A, Delaney M, et al. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. JOGC 2009;31:980–993

Martins HEL, Souza ML, Khanum S, Naz N, Souza ACRH. The practice of nursing in the prevention and control of postpartum hemorrhage: an ıntegrative review. American Journal of Nursing Science 2016;5:8–15

Yasir R, Lakhwani MB, Naz S, Ali Z. Primary postpartum hemorrhage; The effectiveness of uterine massage with active management as compared to active management alone, in the prevention at a tertiary care hospital in Karachi Pakistan. Professional Med J 2016;23:1178–1182

Abdel-Aleem H, Singata M, Abdel-Aleem M, Mshweshwe N, Williams X, Hofmeyr GJ. Uterine massage to reduce postpartum hemorrhage after vaginal delivery. IJGO 2010;111:32–36

Goodin BR, Ness TJ, Robbins MT. Oxytocin – A multifunctional analgesic for chronic deep tissue pain. Curr Pharm Des 2015;21:1–8.

Arslan Özkan H, Bilgin Z. Postpartum kanamalar. Kanıta Dayalı Gebelik ve Doğum Yönetimi. Ankara:Nobel Tıp Kitapevleri;

Downloads

Published

2023-05-30

How to Cite

ABBASI , M., SIDDIQUI , E., GHAFFAR , S., HEMLATA , D., JABEEN , N., & QARSHI , W. (2023). COMPARATIVE STUDY FOR DIFFERENT PREVENTIVE METHODS FOR POSTPARTUM HEMORRHAGE (PPH). Biological and Clinical Sciences Research Journal, 2023(1), 293. https://doi.org/10.54112/bcsrj.v2023i1.293