E-ISSN: 2619-9467

Contents    Cover    Publication Date: 19 Apr 2024
Year 2024 - Volume 34 - Issue 1

Open Access

Peer Reviewed

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Effectiveness of Intermittent Uterine Massage in Reducing Blood Loss During Vaginal Delivery: A Comparative Study

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JCOG. 2024;34(1):19-24
DOI: 10.5336/jcog.2023-98601
Article Language: EN
Copyright Ⓒ 2020 by Türkiye Klinikleri. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Objective: Postpartum haemorrhage (PPH) is the most common cause of maternal mortality in the developing countries. Several interventions have been advocated to reduce the blood loss around the time of childbirth. The aim and primary objective of the present study was to determine the effectiveness of intermittent uterine massage in reducing the blood loss after vaginal delivery. Material and Methods: A quasi-experimental study was conducted on 196 pregnant women. Study group included 98 pregnant women who were given active management of third stage of labour and also uterine massage for 1 minute every 10 minutes for 1 hour after the delivery of the baby and the control group included 98 women who were given only active management of third stage of labour after the delivery. Results: The mean blood loss amongst the study and control group was 139 and 159 mL, respectively (p=0.021). In the control group, 7 women had blood loss of more than 300 mL in comparison to the study group in which only 2 women had blood loss of more than 300 mL, adjusted odd's ratio=8.6 (95% confidence interval 1.05-17.3). In women who had high risk factors for PPH, the mean blood loss was 154 mL in the study group and was 176 mL in the control group (p=0.0204). Conclusion: Intermittent uterine massage is effective in reducing the amount of blood loss during vaginal delivery and also in women with high risk factors for PPH.
  1. Escobar MF, Nassar AH, Theron G, Barnea ER, Nicholson W, Ramasauskaite D, et al; FIGO Safe Motherhood and Newborn Health Committee. FIGO recommendations on the management of postpartum hemorrhage 2022. Int J Gynaecol Obstet. 2022;157 Suppl 1(Suppl 1):3-50. [Crossref]  [PubMed]  [PMC] 
  2. World Health Organization [Internet]. ©2023 WHO [Cited: January 7, 2023]. Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: executive summary. Available from: [Link] 
  3. Meh C, Sharma A, Ram U, Fadel S, Correa N, Snelgrove JW, et al. Trends in maternal mortality in India over two decades in nationally representative surveys. BJOG. 2022;129(4):550-61. [Crossref]  [PubMed]  [PMC] 
  4. Geller SE, Koch AR, Garland CE, MacDonald EJ, Storey F, Lawton B. A global view of severe maternal morbidity: moving beyond maternal mortality. Reprod Health. 2018;15(Suppl 1):98. [Crossref]  [PubMed]  [PMC] 
  5. Horwood G, Opondo C, Choudhury SS, Rani A, Nair M. Risk factors for maternal mortality among 1.9 million women in nine empowered action group states in India: secondary analysis of Annual Health Survey data. BMJ Open. 2020;10(8):e038910. [Crossref]  [PubMed]  [PMC] 
  6. Colalillo EL, Sparks AD, Phillips JM, Onyilofor CL, Ahmadzia HK. Obstetric hemorrhage risk assessment tool predicts composite maternal morbidity. Sci Rep. 2021;11(1):14709. [Crossref]  [PubMed]  [PMC] 
  7. Güngördük K, Olgaç Y, Gülseren V, Kocaer M. Active management of the third stage of labor: A brief overview of key issues. Turk J Obstet Gynecol. 2018;15(3):188-92. [Crossref]  [PubMed]  [PMC] 
  8. International Confederation of Midwives; International Federation of Gynaecologists and Obstetricians. Joint statement: management of the third stage of labour to prevent post-partum haemorrhage. J Midwifery Womens Health. 2004;49(1):76-7. [Crossref]  [PubMed] 
  9. Saccone G, Caissutti C, Ciardulli A, Abdel-Aleem H, Hofmeyr GJ, Berghella V. Uterine massage as part of active management of the third stage of labour for preventing postpartum haemorrhage during vaginal delivery: a systematic review and meta-analysis of randomised trials. BJOG. 2018;125(7):778-81. [Crossref]  [PubMed] 
  10. Aboushady R, Mohamed T, Eid R. Effect of uterine massage and active management during the third stage of labor on reduction of postpartum hemorrhage among high risk women. IOSR Journal of Nursing and Health Science. 2018;7(4):46-57. [Link] 
  11. Hofmeyr GJ, Abdel-Aleem H, Abdel-Aleem MA. Uterine massage for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2013;2013(7):CD006431. [Crossref]  [PubMed]  [PMC] 
  12. Quantification of blood loss: AWHONN practice brief number 1. J Obstet Gynecol Neonatal Nurs. 2015;44(1):158-60. [Crossref]  [PubMed] 
  13. Angarita AM, Cochrane E, Bianco A, Berghella V. Prevention of postpartum hemorrhage in vaginal deliveries. Eur J Obstet Gynecol Reprod Biol. 2023;280:112-9. [Crossref]  [PubMed] 
  14. Erkaya R, Karabulutlu Ö, Çalik KY. Uterine massage to reduce blood loss after vaginal delivery. Health Care Women Int. 2021;44(10-11):1346-62. [Crossref]  [PubMed] 
  15. Ghulmiyyah LM, El-Husheimi A, Usta IM, Colon-Aponte C, Ghazeeri G, Hobeika E, et al. Effect of Sustained Uterine Compression versus Uterine Massage on Blood Loss after Vaginal Delivery: A Randomized Controlled Trial. Am J Perinatol. 2023;40(15):1644-50. [Crossref]  [PubMed] 
  16. Zhang S, Fu X. Uterine massage to reduce blood loss before delivery of the placenta in caesarean section: a retrospective cohort study. Z Geburtshilfe Neonatol. 2021;225(5):428-31. [Crossref]  [PubMed] 
  17. Kundu A, Jana M. Assessment on the effect of active management of third stage of labour with and without uterine massage on maternal outcome among postnatal mothers. International Journal of Research and Review. 2021;8(8):31-9. [Crossref]