A randomized controlled trial to compare the effectiveness of trans-abdominal uterine massage versus sustained uterine compression, started after delivery of the placenta, in reducing blood loss and on maternal pain after a vaginal delivery.
This trial will be a prospective randomized, trial that will be conducted at the American University of Beirut Medical Center - Delivery Suite. Women who are expected to deliver vaginally will be evaluated for potential participation during their prenatal care during the last 2 months of pregnancy at the Women’s Health Center (WHC) or Outpatient Department (OPD). They will be handled the IRB-approved consent form and will be given enough time to read it and return signed in the next antenatal visit. If they are not followed up at these facilities, they will be approached upon presentation to the Delivery Suite.
- Study subjects will be randomized using a computer-generated random number sequence to a 1:1 ratio.
- At delivery, a sealed opaque envelope containing the randomization number and data sheet will be opened by the PGYII immediately after delivery of the placenta, for each consenting patient.
- As a result of the nature of the intervention, neither participants nor research staff will be blinded to group allocation.
Inclusion criteria include women giving birth vaginally, aged between 20 and 40 years, with a singleton pregnancy, gestational age of 36 or more weeks, and with fewer than three previous childbirths.
Exclusion criteria include multiple gestation, fetal malpresentation, the third stage of labor lasting more than 30 minutes, a previous cesarean delivery, chorioamnionitis, three or more previous induced abortions, hypertensive disorders of pregnancy, fetal death, polyhydramnios, hemoglobin of 9 g/L or less before delivery, coagulopathy, on magnesium sulfate infusion, abruptio placentae and having an abdominal wall too thick to palpate the fundus of the uterus or to perform uterine massage or compressions after delivery. Screening for eligibility will be accomplished by checking the medical record. Baseline information will collected from each participant.