OBJECTIVE: To determine the effectiveness of sustained uterine massage started before delivery of the placenta in reducing postpartum hemorrhage. METHODS: A randomized controlled trial conducted in Egypt and South Africa between September 2006 and February 2009. A total of 1964 pregnant women were randomly allocated to 1 of 3 treatment groups: intramuscular oxytocin, sustained uterine massage, or both treatments. Blood loss within 30 minutes of delivery was recorded. RESULTS: The incidence of blood loss of 300 mL or more within 30 minutes of delivery was significantly higher in the massage group than in the massage plus oxytocin (RR 1.88; 95% CI, 1.29-2.74 in Assiut, and RR 1.3; 95% CI, 1.00-1.68 in SA) and the oxytocin only group (RR 1.7; 95% CI, 1.11-2.61 in Assiut, and RR 2.24; 95% CI, 1.54-3.27 in SA). In both centers, use of additional uterotonics was significantly higher in the uterine massage group compared with the other 2 groups. CONCLUSION:Uterine massage was less effective than oxytocin for reducing blood loss after delivery. When oxytocin was used, there was no additional benefit from uterine massage. The effectiveness of uterine massage in the absence of oxytocin was not studied. ACTRN: 12609000372280.
RCT Entities:
OBJECTIVE: To determine the effectiveness of sustained uterine massage started before delivery of the placenta in reducing postpartum hemorrhage. METHODS: A randomized controlled trial conducted in Egypt and South Africa between September 2006 and February 2009. A total of 1964 pregnant women were randomly allocated to 1 of 3 treatment groups: intramuscular oxytocin, sustained uterine massage, or both treatments. Blood loss within 30 minutes of delivery was recorded. RESULTS: The incidence of blood loss of 300 mL or more within 30 minutes of delivery was significantly higher in the massage group than in the massage plus oxytocin (RR 1.88; 95% CI, 1.29-2.74 in Assiut, and RR 1.3; 95% CI, 1.00-1.68 in SA) and the oxytocin only group (RR 1.7; 95% CI, 1.11-2.61 in Assiut, and RR 2.24; 95% CI, 1.54-3.27 in SA). In both centers, use of additional uterotonics was significantly higher in the uterine massage group compared with the other 2 groups. CONCLUSION: Uterine massage was less effective than oxytocin for reducing blood loss after delivery. When oxytocin was used, there was no additional benefit from uterine massage. The effectiveness of uterine massage in the absence of oxytocin was not studied. ACTRN: 12609000372280.
Authors: Elizabeth M McClure; Doris J Rouse; Emily R Macguire; Bonnie Jones; Jennifer B Griffin; Alan H Jobe; Beena D Kamath-Rayne; Craig Shaffer; Robert L Goldenberg Journal: Int J Gynaecol Obstet Date: 2013-01-11 Impact factor: 3.561
Authors: Cecily M Begley; Gillian Ml Gyte; Declan Devane; William McGuire; Andrew Weeks; Linda M Biesty Journal: Cochrane Database Syst Rev Date: 2019-02-13
Authors: Jennifer A Salati; Sebastian J Leathersich; Myfanwy J Williams; Anna Cuthbert; Jorge E Tolosa Journal: Cochrane Database Syst Rev Date: 2019-04-29
Authors: Ioannis D Gallos; Helen M Williams; Malcolm J Price; Abi Merriel; Harold Gee; David Lissauer; Vidhya Moorthy; Aurelio Tobias; Jonathan J Deeks; Mariana Widmer; Özge Tunçalp; Ahmet Metin Gülmezoglu; G Justus Hofmeyr; Arri Coomarasamy Journal: Cochrane Database Syst Rev Date: 2018-04-25