Postpartum Hemorrhage
Conditions
Keywords
postpartum hemorrhage, uterine atony, shear wave, elastography
Brief summary
Prospective study evaluating the feasibility of shear-wave elastography of the uterus during the third stage of labour and following placental delivery. The investigators hypothesize that the stiffness of the myometrium can be measured by using shear-wave technology. This study involves 30 patients with a healthy pregnancy and spontaneous vaginal delivery. One co-investigator will carry out measurements at the uterine fundus, at three different time points: after fetal delivery, after placental delivery and 30 minutes after placental delivery.
Interventions
DIAGNOSTIC_TESTShear wave elastography
Investigate the feasibility of use of shear-wave elastography of the uterus during the third stage of labour and following placental delivery in order to predict uterine atony .
Sponsors
Centre Hospitalier Universitaire Vaudois
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 35 Years
Inclusion criteria
* singleton pregnancy * cephalic presentation * maternal age \> 18 years old * nulliparous * healthy uncomplicated pregnancy * gestational age between 37-42 weeks of gestation * spontaneous labour and delivery * uncomplicated progression of labour (cervical dilatation at \>1 cm/h) * administration of less than 3 units of oxytocin during the second stage of labour * patient having read, accepted and signed the consent form
Exclusion criteria
* antepartum hemorrhage in the present pregnancy * protracted second stage of labour (more than two hours from full dilatation to delivery) * more than 30 minutes of active pushing * BMI \> 35 kg/m2 * distance from skin to uterus \> 8 cm * age \> 35 years old * instrumental deliveries * bleeding disorders * polyhydramnios * diabetes * pre-eclampsia * high blood pressure * use of anticoagulant medications * clinical chorioamnionitis * placental abnormality (low-lying or abruption) * fetal macrosomia * uterine fibroids * uterine anomalies * previous uterine scar * multiple pregnancy * placental retention * inability to follow procedures or insufficient knowledge of project language * inability to give consent * refusal to participate
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stiffness of the myometrium | Third labor stage to 30 minutes post placenta delivery | Difference in median myometrial shear wave velocity between each time point: after fetal delivery, after placental delivery and 30 minutes after placental delivery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood loss | Two hours following the childbirth | Measurement of total blood loss |
Countries
Switzerland
Outcome results
None listed