Lower Uterine Segment Compression for 20 Minutes to
Prevent Early Postpartum Hemorrhage
Wisude Anansakunwat MD1, Wiwat Iamurairat MD2, Preeyaporn Boonyoung MNS3
Affiliation :
1 Department of Obstetrics and Gynecology, Charoenkrung Pracharak Hospital, Medical Service Department Bangkok Metropolitan
Administration, Thailand
2 Department of Obstetrics and Gynecology, Sirindhorn Hospital, Medical Service Department Bangkok Metropolitan Administration, Thailand
3 Labor Room, Sirindhorn Hospital, Medical Service Department Bangkok Metropolitan Administration, Thailand
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 signi(cid:976)icantly
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
signi(cid:976)icantly 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 signi(cid:976)icantly lower the blood loss in the treatment
group. It would be bene(cid:976)icial to prevent PPH and maternal death.
Keywords : Lower uterine segment compression, Postpartum hemorrhage, PPH prevention, PPH innovation, LUSC
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