Comparison of active vs. expectant management of the third stage of labor in women with low risk of postpartum hemorrhage: A randomized controlled trial

dc.contributor.authorYıldırım, Do?ukan
dc.contributor.authorÖzyürek, Şefik Eser
dc.contributor.authorEkiz, Ali
dc.contributor.authorEren Çiler, Elif
dc.contributor.authorHendem Uyan, Derya
dc.contributor.authorBafalı, Olgu
dc.contributor.authorSeçkin Doğa, Kerem
dc.date.accessioned2020-07-14T10:21:55Z
dc.date.available2020-07-14T10:21:55Z
dc.date.issued2016
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
dc.description.abstractObjectives: To compare the ‘strictly’ active management protocol in women with low risk of postpartum hemorrhage using the expectant management protocol with respect to changes in hematologic parameters, uterotonics, blood transfusions, or additional interventions. Material and methods: A randomized controlled prospective trial in which 934 singleton parturients enrolled; 654 were randomly assigned to the active and mixed management groups. The primary outcome parameter was the reduction in hemoglobin concentrations due to delivery, and the secondary outcome parameters were changes in hemoglobin of more than 3 g/dL (?Hb ? 3 g/dL), durations of the third stage of labor, need for additional uterotonic agents, blood transfusions, manual removal of the placenta, and surgical evacuation of retained products of conception. Results: The mean postpartum hemoglobin concentration was significantly higher (P = 0.04) in the active management group with a significantly lower reduction (P = 0.03). Falls of hemoglobin levels of more than 3 g/dL (?Hb ? 3g/dL) were less common in the active management group though not significantly (P = 0.32). The mean duration of the third stage of labor was significantly (P < 0.001) shorter in the active management group. There was no significant difference between the two groups with regard to the need for additional uterotonic agents, uterine atony, blood transfusion, manual removal of the placenta, surgical evacuation of retained products of conception, and prolonged third stage of labor. Conclusions: Although active management of the third stage of labor was associated with higher postpartum hemoglobin levels, it did not influence the risk of ‘severe postpartum hemorrhage’ in women with low risk of postpartum hemorrhage.
dc.identifier.citationYıldırım, D., Özyürek, Ş. E., Ekiz, A., Eren Çiler, E., Hendem Uyan, D., Bafalı, O. ve Seçkin Doğa, K. (2016). Comparison of active vs. expectant management of the third stage of labor in women with low risk of postpartum hemorrhage: A randomized controlled trial. Ginekologia Polska, 87(5), 399-404. https://dx.doi.org/10.5603/GP.2016.0015
dc.identifier.doi10.5603/GP.2016.0015
dc.identifier.endpage404
dc.identifier.issn0017-0011
dc.identifier.issue5
dc.identifier.scopusqualityQ3
dc.identifier.startpage399
dc.identifier.urihttps://dx.doi.org/10.5603/GP.2016.0015
dc.identifier.urihttps://hdl.handle.net/20.500.12511/5485
dc.identifier.volume87
dc.identifier.wosqualityQ4
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherVia Medica
dc.relation.ispartofGinekologia Polskaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPostpartum Hemorrhage
dc.subjectActive Management
dc.subjectExpectant Management
dc.subjectControlled Cord Traction
dc.subjectThird Stage of Labor
dc.titleComparison of active vs. expectant management of the third stage of labor in women with low risk of postpartum hemorrhage: A randomized controlled trial
dc.typeArticle

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