2.50
Hdl Handle:
http://hdl.handle.net/10755/159772
Type:
Presentation
Title:
Prevention of Post Partum Hemorrhage in a Low Resource Setting
Abstract:
Prevention of Post Partum Hemorrhage in a Low Resource Setting
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Low, Lisa, CNM PhD
P.I. Institution Name:Univesity of Michigan
Contact Address:400 North Ingalls, Rm 3249, Ann Arbor, MI, 48109, USA
Contact Telephone:734-647-0334
Co-Authors:L.K. Low, Health Promotion, University of Michigan, Ann Arbor, MI; L.K. Low, J. Bailey, , University of Michigan Health System, Ann Arbor, MI;
Post partum hemorrhage (PPH) accounts for almost 80% of maternal deaths in low resource settings. To avert the risk of PPH active management of third stage labor (AMTSL) the global health community has advocated for AMTSL as an effective, evidence based method of prevention. AMTSL includes administration of a uterotonic agent with delivery of the shoulder, controlled cord traction following administration of the agent, typically pitocin, and uterine massage. Despite its value, there are challenges to implementing AMTSL as a life saving strategy including limited access to uterotonic agents and training in the method. The study aim was to evaluate the effectiveness of AMTSL in a low resource birth center setting in rural Honduras. A pre and post intervention design was used to assess the incidence of PPH before and after the introduction of AMTSL for all vaginal births at Centro Materno Infantil (CMI) Morazan, Honduras. Nurses who conduct vaginal births at CMI were trained to estimate blood loss (EBL) and in year one we prospectively collected data related to risk of PPH and EBL Then nurses were trained in AMTSL for year two. All the births conducted at CMI then included this intervention. At the end of year two, the rates of PPH were compared. In year one, 229 women gave birth at the CMI for which data was collected related to EBL and in year 2, 335 women had a vaginal birth which included AMTSL. There were no significant differences between the two in demographics and obstetric outcomes. There was a significant difference in average blood loss prior to AMTSL which was 307.9 ml when pitocin was given post partum but not consistent with AMTSL and 438 without pitocin being given (P=0.006). When AMTSL was performed, the average EBL was 248 ml, a significant difference compared to prior to AMTSL. The incidence of PPH in year 1 was 15% and 6% in year 2, representing a significant reducting in the incidence of PPH when using AMTSL. AMTSL is an evidence based strategy that reduces PPH when implemented in low resource settings. These results demonstrate that teaching and implementing AMTSL, results in reductiona in PPH. This lifesaving measure should be encouraged in all settings to prevent the risk of PPH, particularly in low resource settings.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePrevention of Post Partum Hemorrhage in a Low Resource Settingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159772-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Prevention of Post Partum Hemorrhage in a Low Resource Setting</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Low, Lisa, CNM PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Univesity of Michigan</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">400 North Ingalls, Rm 3249, Ann Arbor, MI, 48109, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">734-647-0334</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kanelow@umich.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">L.K. Low, Health Promotion, University of Michigan, Ann Arbor, MI; L.K. Low, J. Bailey, , University of Michigan Health System, Ann Arbor, MI;</td></tr><tr><td colspan="2" class="item-abstract">Post partum hemorrhage (PPH) accounts for almost 80% of maternal deaths in low resource settings. To avert the risk of PPH active management of third stage labor (AMTSL) the global health community has advocated for AMTSL as an effective, evidence based method of prevention. AMTSL includes administration of a uterotonic agent with delivery of the shoulder, controlled cord traction following administration of the agent, typically pitocin, and uterine massage. Despite its value, there are challenges to implementing AMTSL as a life saving strategy including limited access to uterotonic agents and training in the method. The study aim was to evaluate the effectiveness of AMTSL in a low resource birth center setting in rural Honduras. A pre and post intervention design was used to assess the incidence of PPH before and after the introduction of AMTSL for all vaginal births at Centro Materno Infantil (CMI) Morazan, Honduras. Nurses who conduct vaginal births at CMI were trained to estimate blood loss (EBL) and in year one we prospectively collected data related to risk of PPH and EBL Then nurses were trained in AMTSL for year two. All the births conducted at CMI then included this intervention. At the end of year two, the rates of PPH were compared. In year one, 229 women gave birth at the CMI for which data was collected related to EBL and in year 2, 335 women had a vaginal birth which included AMTSL. There were no significant differences between the two in demographics and obstetric outcomes. There was a significant difference in average blood loss prior to AMTSL which was 307.9 ml when pitocin was given post partum but not consistent with AMTSL and 438 without pitocin being given (P=0.006). When AMTSL was performed, the average EBL was 248 ml, a significant difference compared to prior to AMTSL. The incidence of PPH in year 1 was 15% and 6% in year 2, representing a significant reducting in the incidence of PPH when using AMTSL. AMTSL is an evidence based strategy that reduces PPH when implemented in low resource settings. These results demonstrate that teaching and implementing AMTSL, results in reductiona in PPH. This lifesaving measure should be encouraged in all settings to prevent the risk of PPH, particularly in low resource settings.</td></tr></table>en_GB
dc.date.available2011-10-26T22:19:12Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:19:12Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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