Uterine Massage Doesn't Cut Post-Delivery Blood Loss
(HealthDay News) – For women who deliver vaginally, the addition of transabdominal uterine massage to oxytocin following the delivery of the placenta does not reduce blood loss compared with oxytocin alone, according to a study published online July 8 in Obstetrics & Gynecology.
Meng Chen, MD, from West China Second University Hospital of Sichuan University in Chengdu, and colleagues conducted a randomized controlled trial involving 2,340 women who delivered vaginally. Participants were randomized in a 1:1 ratio to receive 10 units oxytocin intramuscularly immediately following delivery of the shoulder plus 30 minutes of sustained transabdominal uterine massage after delivery of the placenta or to oxytocin alone.
The researchers found that, based on intent-to-treat analyses with a power of >0.8, the incidence of blood loss of ≥400mL in the two hours after delivery did not differ significantly between the groups (12.2% and 12.3%, respectively). No significant differences were noted between the groups with respect to secondary outcomes, including blood loss of ≥1,000mL, blood loss in the two hours after delivery, use of therapeutic uterotonics or other hemostatic procedures, hemoglobin of lower than 80g/L before discharge, and need for blood transfusion.
"Routine uterine massage provides no additional benefit when combined with oxytocin administration and therefore may not be a necessary step for the prevention of postpartum hemorrhage after vaginal delivery," the authors write. "Elimination of routine uterine massage from active management of the third stage of labor will help obstetric staff spare more time and efforts for other work."