OBJECTIVES: To review the literature to determine the most effective methods for preventing postpartum hemorrhage (PPH), the single most important cause of maternal death worldwide. METHODS: Systematic review of published randomized controlled trials and relevant reviews. RESULTS: Review of the literature confirms that active management of the third stage of labor, especially the administration of uterotonic drugs, reduces the risk of PPH due to uterine atony without increasing the incidence of retained placenta or other serious complications. Oxytocin is the preferred uterotonic drug compared with syntometrine, but misoprostol also can be used to prevent hemorrhage in situations where parenteral medications are not available (e.g. at home births in developing countries). CONCLUSIONS: The use of active management of the third stage of labor to prevent PPH due to uterine atony should be expanded, especially in developing country settings.
OBJECTIVES: To review the literature to determine the most effective methods for preventing postpartum hemorrhage (PPH), the single most important cause of maternal death worldwide. METHODS: Systematic review of published randomized controlled trials and relevant reviews. RESULTS: Review of the literature confirms that active management of the third stage of labor, especially the administration of uterotonic drugs, reduces the risk of PPH due to uterine atony without increasing the incidence of retained placenta or other serious complications. Oxytocin is the preferred uterotonic drug compared with syntometrine, but misoprostol also can be used to prevent hemorrhage in situations where parenteral medications are not available (e.g. at home births in developing countries). CONCLUSIONS: The use of active management of the third stage of labor to prevent PPH due to uterine atony should be expanded, especially in developing country settings.
Authors: Suellen Miller; Mohamed M F Fathalla; Oladosu A Ojengbede; Carol Camlin; Mohammed Mourad-Youssif; Imran O Morhason-Bello; Hadiza Galadanci; David Nsima; Elizabeth Butrick; Tarek Al Hussaini; Janet Turan; Carinne Meyer; Hilarie Martin; Aminu I Mohammed Journal: BMC Pregnancy Childbirth Date: 2010-10-18 Impact factor: 3.007
Authors: G Justus Hofmeyr; A Metin Gülmezoglu; Natalia Novikova; Verena Linder; Sandra Ferreira; Gilda Piaggio Journal: Bull World Health Organ Date: 2009-09 Impact factor: 9.408
Authors: Mohamed M F Fathalla; Mohammed Mourad Youssif; Carinne Meyer; Carol Camlin; Janet Turan; Jessica Morris; Elizabeth Butrick; Suellen Miller Journal: ISRN Obstet Gynecol Date: 2011-08-10
Authors: Pili Ferrer; Ian Roberts; Emma Sydenham; Karen Blackhall; Haleema Shakur Journal: BMC Pregnancy Childbirth Date: 2009-07-15 Impact factor: 3.007
Authors: Judith T Fullerton; Kevin D Frick; Linda A Fogarty; Joy D Fishel; Donna M Vivio Journal: J Health Popul Nutr Date: 2006-12 Impact factor: 2.000