Cherine M, Khalil K, Hassanein N, Sholkamy H, Breebaart M, Elnoury A
Galaa Hospital, Cairo, Egypt.
Int J Gynaecol Obstet. 2004 Oct;87(1):54-8. doi: 10.1016/j.ijgo.2004.05.013.
The study describes normal labor practices in an Egyptian teaching hospital for the first time, where postpartum hemorrhage is the leading cause of maternal mortality. Third-stage management patterns are described and compared to evidence-based medicine. Reasons for third-stage practices observed are explored.
176 normal births were directly observed. Women were interviewed postpartum and study findings were shared with providers.
Third-stage active management was correctly done for 15% of women observed. Most common deviations for the remaining 85% were: giving uterotonic drugs after placental delivery (65%) and without cord traction (49%). Passive management was not done for any observed delivery.
The preventive role actively managing the third stage can provide against postpartum hemorrhage was lost to the majority of the deliveries observed. Obstacles to adopting protocols shown to reduce hemorrhage should be explored, given the contribution of postpartum hemorrhage to maternal deaths in Egypt.
本研究首次描述了埃及一家教学医院的正常分娩情况，在该医院产后出血是孕产妇死亡的主要原因。描述了第三产程的管理模式并与循证医学进行比较。探讨了观察到的第三产程操作的原因。
直接观察了176例正常分娩。对产妇进行产后访谈，并将研究结果与医护人员分享。
观察到的产妇中，15%正确实施了第三产程积极管理。其余85%最常见的偏差是：胎盘娩出后给予宫缩剂（65%）且未进行脐带牵引（49%）。所有观察到的分娩均未进行被动管理。
对于大多数观察到的分娩，积极管理第三产程预防产后出血的作用丧失了。鉴于产后出血对埃及孕产妇死亡的影响，应探讨采用已证明可减少出血的方案的障碍。
