If the uterine contraction was
not as anticipated, the subjects in both groups were treated with ergometrine 0.2 mg intravenously,
plus oxytocin 10 units. If the mothers developed
excess blood loss, they received Nalador or blood
replacement. After the delivery of the placenta,
episiotomy wound was repaired subsequently. The
blood loss was observed until two hours after birth.
The amount of blood loss was recorded. All soaking
drapes and blood in a bucket were weighed, measuring
as 1 g = 1 ml. The well-trained registered nurses were
assigned to record the result in the Record Form.
All participants provided written consent
after receiving a full explanation of the survey. The
present study was approved by the Ethics Committee
of the institution. All procedures were conducted in
accordance with the ethical principles defined in the
Declaration of Helsinki.
LUSC can be divided into two techniques,
consisting of 1) using one hand (or both) to compress
the lower uterine segment as hard as possible as long
as the mother could tolerate it (Fig. 1) and 2) using one
hand to compress the lower uterine segment and another
hand compressing the uterine fundus, like bimanual
uterine compression (Fig. 2). The first maneuver is
appropriate for women whose abdominal walls are thick,
such as obese women and primigravid pregnancies,
whereas slimmer women and women with multiparity
can gain the benefit of the second maneuver. In the
present study, the first maneuver was used.
The sample size was calculated by the basis
of 10% PPH rate
(23)
. To reduce these to 5%, 343 cases in
each arm are required to achieve a power of 80% in
detecting a statistically significant difference, at a 90%
confidence level.
Data analysis was performed with statistical
software. The variables were compared. Student’s t test
or Mann-Whitney U test was used for quantitative
data and Chi-square or Fisher exact test was used for
qualitative data. All statistical tests were 2-sided. A
p-value < 0.05 was considered statistically significant.
Results
Chareonkrung Pracharak is a general hospital
that has a capacity of 400 beds. There are approximately
5,000 births annually. There were 5% PPH in average.
Six hundred eighty six cases of singleton pregnant
women were enrolled in the present study. Nine subjects
were excluded, consisting of five cases in the control
group and four cases in the experimental group. All
cases in the control group were detected with
retained placenta whereas in the experimental group,
each case was found to have retained placenta,
Fig. 1 Lower uterine segment compression method in
treatment of acute postpartum hemorrhage by
compressing at the lower uterine segment only
Fig. 2 Lower uterine segment compression method in
treatment of acute postpartum hemorrhage by
compressing at the lower uterine segment with
counteracting pressure from fundus
retained placental fragments, deep perineum tear, and
hematoma (Fig. 3).
For maternal baseline characteristics, no
statistical differences were observed between the
groups in terms of maternal age, gravidity, gestational
age, body mass index (BMI), past history of PPH, the
levels of hemoglobin and hematocrit, and platelet
concentration (Table 1).
In antepartum or intrapartum period, no
statistical differences were observed between the two