The LENTE Study: The Effectiveness of Prophylactic Intramuscular Oxytocin in the Third Stage of Labor Among Low-Risk Women in Primary Care Midwifery Practice: A Randomized Controlled Trial
| Autor: | Marlies Rijnders, Mariet Th. van Diem, Suze Jans, K. Herschderfer, S.E. Buitendijk, Mieke Aitink, Karin M. van der Pal-de Bruin |
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| Rok vydání: | 2016 |
| Předmět: |
primary midwifery care
medicine.medical_specialty Maternal and child health Breastfeeding Primary care EXPECTANT MANAGEMENT Third stage management law.invention 03 medical and health sciences 0302 clinical medicine BLOOD-LOSS Life Randomized controlled trial CH - Child Health law Multicenter trial Maternity and Midwifery medicine COHORT Primary midwifery care 030219 obstetrics & reproductive medicine ACTIVE MANAGEMENT 030504 nursing Obstetrics business.industry third stage management Obstetrics and Gynecology maternal and child health Confidence interval Postpartum hemorrhage postpartum hemorrhage Oxytocin Health Relative risk Cohort ELSS - Earth Life and Social Sciences Healthy for Life 0305 other medical science business Healthy Living medicine.drug |
| Zdroj: | International Journal of Childbirth, 3, 16, 173-182 International journal of childbirth, 6(3), 173-182. Springer |
| ISSN: | 2156-5295 2156-5287 |
| DOI: | 10.1891/2156-5287.6.3.173 |
| Popis: | PURPOSE:To test third stage management of labor for low-risk women comparing routine prophylactic intramuscular oxytocin management versus modified expectant management.STUDY DESIGN:Randomized controlled multicenter trial in primary care midwifery practice.MAJOR FINDINGS:32.4% of women in the prophylactic intramuscular oxytocin management group had blood loss of 500 mL or more versus 44.2% in the modified expectant management group, relative risk (RR) 0.61, 95% confidence interval (CI) [0.50, 0.74]. The percentage of women experiencing postpartum hemorrhage (PPH) defined as more than 1,000 mL blood loss was 6.3% in the prophylactic intramuscular oxytocin management group versus 11.9% in the modified expectant management group (RR 0.50, 95% CI [0.36, 0.71]). The type of management showed no significant differences between the two groups in clinically relevant indicators of women’s short-term health such as the number of referrals, treatment given, hemoglobin level 36 hours postpartum, and breastfeeding rates after 1 week. Medium-term health such as hemoglobin level at 6 weeks postpartum, women’s perceptions of tiredness, and breastfeeding rates at 3 months after birth also showed no differences between the two groups.CONCLUSION:Third stage management by means of routine prophylactic intramuscular oxytocin reduced the risk of postpartum hemorrhage in a group of childbearing women at low risk of complications in primary midwifery care compared to modified expectant third stage management, but there was no evidence this was associated with a reduction in clinically relevant adverse health outcomes. |
| Databáze: | OpenAIRE |
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