Abstract

PILOTO PADRON, Mercedes; CRUZ SILVA, Dianelys; AGUILA SETIEN, Sonia  and  PERNAS GONZALEZ, Abel. Maternal impact of the active management of accouchement. Rev Cubana Obstet Ginecol [online]. 2010, vol.36, n.3, pp. 322-332. ISSN 1561-3062.

According to World Health Organization (WHO) about 500 000 women die annually across the world from causes related to pregnancy and childbirth. Haemorrhage is the main cause of maternal death. It has been estimated that at least 25 % of these deaths are due to haemorrhage - the majority due to postpartum haemorrhage. One intervention that has been promoted as effective to prevent the post partum haemorrhage is the active management of the third stage of labour, this intervention started in our country in 2005. OBJECTIVES: To evaluate the impact of the introduction of the active management of the third stage of labour over occurred of the post partum haemorrhage and serius maternal complications in 2005 in "Eusebio Hernandez" hospital. METHODS: Observational, comparative and retrospective study of 804 clinical reports from women with vaginal delivery and expectant management of the third stage of labour in 2003 and 820 women with vaginal delivery and active management of the third stage of labour in 2005. RESULTS: Active management was associated with the reduction of: post partum haemorrhage (relative risk 0.52, 95 % confidence interval 0.44 to 0.61) and blood transfusion (RR: 0.27; CI 95 %: 0.10 to 0.73), the increase of hematocrit reduction (RR: 0.56; CI 95 %: 0.48 to 0.65) and absence of adverse maternal outcomes. CONCLUSIONS: Routine active management is superior to expectant management in terms of blood loss, post partum haemorrhage and maternal outcomes.

Keywords : Pregnancy; labour; post partum hemorrhage.

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