Objective: Primary objective is to compare the incidence of early postpartum hemorrhage [PPH] between mothers who only received active management of third stage of labor [AMTSL] and mothers who receive both AMTSL and 20 minutes of lower uterine segment compression [LUSC] during the third stage of birth. Secondary objective is to compare the volume of blood loss between mothers who only received AMTSL and mothers who receive both AMTSL and 20 minutes of LUSC during the third stage of birth.

Materials and Methods: The randomized clinical control trial was performed in labor rooms of Sirindhorn Hospital between May and June of 2014. Subjects included 306 mothers with natural vaginal delivery. In control group, 153 mothers received only AMTSL. For treatment group, 153 mothers received AMTSL together with 20 minutes of LUSC after birth. Collect the blood lost through vagina until the suture was done and up to 2 hours after birth.

Results: One mother was excluded from the control group due to retained placenta. It was found that LUSC could reduce significantly the incidence rate of PPH from 10.5% (16 in 152) to 2.0% (3 in 153) with p = 0.002, and the blood loss in the treatment group was significantly lower than that of the control group (263.2±117.5 vs. 304.3±219.7, p = 0.043).

Conclusion: LUSC for 20 minutes can decrease the incidence of PPH by 81.3% and significantly lower the blood loss in the treatment group. It would be beneficial to prevent PPH and maternal death.

Keywords: Lower uterine segment compression, Postpartum hemorrhage, PPH prevention, PPH innovation, LUSC