Postpartum Hemorrhage
Conditions
Brief summary
Throughout the history, the neonate was dependent on maternal touch and care for survival. In modern obstetrics, with hospital care the neonates are seldom separated from their mothers after delivery. Early skin to skin (ESTS) contact after delivery was found to increase milk production, lactation and improve maternal and neonatal outcome. Oxytocin is the primary hormone responsible for uterine contraction and prevention of postpartum hemorrhage (PPH). ESTS contact increases oxytocin secretion. The rate of cesarean deliveries (CDs) increased dramatically over the past decades. CD was found to decrease postpartum milk production, postpones early lactation and decreases exclusive breastfeeding. During the typical CD, the neonate is usually presented for a short while to the mother and breastfeeding is usually delayed at least a number of hours until after the surgery and the recovery period. Natural CD, enable ESTS contact during the surgery and give the mother the opportunity to start breastfeeding immediately after delivery of the neonate in the surgery suit. Oxytocin secretion increases with ESTS and during breastfeeding. The aim of this study is to examine blood loss that occurs after Natural CD compared to standard CD without an ESTS contact.
Interventions
OTHERStandard cesarean delivery
Standard cesarean delivery
OTHERNatural cesarean delivery
Natural cesarean delivery
Sponsors
Raed Salim
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
8 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* Estimated to be appropriate for gestational age fetus. * Sonographic dating before 20 weeks of gestation.
Exclusion criteria
* Non-scheduled CD. * Major fetal malformations. * Multiple gestations. * Non-controlled diabetes. * Severe pre-eclampsia. * General anesthesia. * HIV carrier * Neonatal need for early resuscitation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hemoglobin level after delivery | 4 days | Difference between pre- and post-surgical hemoglobin levels. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pain score during the operation | 1 hour | — |
| Pain score during the first day after cesarean delivery | 24 hours | Use of analgesic drugs |
| Analgesia use during the operation | 1 hour | Use of analgesic drugs |
| Analgesia use during the first day after cesarean delivery | 24 hours | — |
| Blood product transfusion | 4 days | Number of Packed red blood cells and plasma products |
| Rate of breastfeeding 6 months after delivery | 6 months | — |
| Maternal satisfaction of the delivery | 4 days | Satisfaction scale |
| Breast engorgement | 4 days | Diagnosed by physical examination |
| Neonatal temperature after delivery | 1 hour | Temperature |
| Rate of breastfeeding at maternal hospital discharge | 4 days | — |
Countries
Israel
Outcome results
None listed