Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data

Plain Language Summary The duration of the third stage of labour (TSL) seems to be an important risk factor for greater postpartum blood loss, as literature shows that a longer TSL can be associated with more blood loss. Active management of third stage of labour (AMTSL), included in the WHO guideli...

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Autores principales:	Sumangala B. Chikkamath, Geetanjali M. Katageri, Ashalata A. Mallapur, Sunil S. Vernekar, Manjunath S. Somannavar, Gilda Piaggio, Guillermo Carroli, José Ferreira de Carvalho, Fernando Althabe, G. Justus Hofmeyr, Mariana Widmer, Ahmet Metin Gulmezoglu, Shivaprasad S. Goudar
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Third stage of labour Postpartum blood loss Duration Heat-stable carbetocin Uterotonics Oxytocin Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/b7d75c63f28c40fda75c7281d15df55b
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spelling	oai:doaj.org-article:b7d75c63f28c40fda75c7281d15df55b2021-11-21T12:31:32ZDuration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data10.1186/s12978-021-01284-81742-4755https://doaj.org/article/b7d75c63f28c40fda75c7281d15df55b2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12978-021-01284-8https://doaj.org/toc/1742-4755Plain Language Summary The duration of the third stage of labour (TSL) seems to be an important risk factor for greater postpartum blood loss, as literature shows that a longer TSL can be associated with more blood loss. Active management of third stage of labour (AMTSL), included in the WHO guidelines for prevention of postpartum haemorrhage (PPH), is effective in reducing both the amount of postpartum blood loss and the duration of the third stage. To better describe the association between duration of TSL and postpartum blood loss in women receiving AMTSL, we conducted this secondary analysis of WHO CHAMPION trial data. To assess the association between the duration of third stage of labour and postpartum blood loss, a subcohort of the CHAMPION modified ITT population was selected by excluding women with missing blood loss or missing TSL duration or TSL duration more than 60 min and women with interventions. Thus, the subcohort consisted of 10,040 women. In women with vaginal birth and not receiving interventions for treating atonic PPH or other sources of bleeding, and with TSL duration up to 60 min, there was a positive association between duration of the TSL and postpartum blood loss. The blood loss rose steeply with duration in women with TSL of 10 min or less, while in women with longer TSL duration the slope was less steep. There was no evidence of a difference between oxytocin and HS carbetocin in the pattern of association of duration of the TSL and blood loss.Sumangala B. ChikkamathGeetanjali M. KatageriAshalata A. MallapurSunil S. VernekarManjunath S. SomannavarGilda PiaggioGuillermo CarroliJosé Ferreira de CarvalhoFernando AlthabeG. Justus HofmeyrMariana WidmerAhmet Metin GulmezogluShivaprasad S. GoudarBMCarticleThird stage of labourPostpartum blood lossDurationHeat-stable carbetocinUterotonicsOxytocinGynecology and obstetricsRG1-991ENReproductive Health, Vol 18, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Third stage of labour Postpartum blood loss Duration Heat-stable carbetocin Uterotonics Oxytocin Gynecology and obstetrics RG1-991
spellingShingle	Third stage of labour Postpartum blood loss Duration Heat-stable carbetocin Uterotonics Oxytocin Gynecology and obstetrics RG1-991 Sumangala B. Chikkamath Geetanjali M. Katageri Ashalata A. Mallapur Sunil S. Vernekar Manjunath S. Somannavar Gilda Piaggio Guillermo Carroli José Ferreira de Carvalho Fernando Althabe G. Justus Hofmeyr Mariana Widmer Ahmet Metin Gulmezoglu Shivaprasad S. Goudar Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
description	Plain Language Summary The duration of the third stage of labour (TSL) seems to be an important risk factor for greater postpartum blood loss, as literature shows that a longer TSL can be associated with more blood loss. Active management of third stage of labour (AMTSL), included in the WHO guidelines for prevention of postpartum haemorrhage (PPH), is effective in reducing both the amount of postpartum blood loss and the duration of the third stage. To better describe the association between duration of TSL and postpartum blood loss in women receiving AMTSL, we conducted this secondary analysis of WHO CHAMPION trial data. To assess the association between the duration of third stage of labour and postpartum blood loss, a subcohort of the CHAMPION modified ITT population was selected by excluding women with missing blood loss or missing TSL duration or TSL duration more than 60 min and women with interventions. Thus, the subcohort consisted of 10,040 women. In women with vaginal birth and not receiving interventions for treating atonic PPH or other sources of bleeding, and with TSL duration up to 60 min, there was a positive association between duration of the TSL and postpartum blood loss. The blood loss rose steeply with duration in women with TSL of 10 min or less, while in women with longer TSL duration the slope was less steep. There was no evidence of a difference between oxytocin and HS carbetocin in the pattern of association of duration of the TSL and blood loss.
format	article
author	Sumangala B. Chikkamath Geetanjali M. Katageri Ashalata A. Mallapur Sunil S. Vernekar Manjunath S. Somannavar Gilda Piaggio Guillermo Carroli José Ferreira de Carvalho Fernando Althabe G. Justus Hofmeyr Mariana Widmer Ahmet Metin Gulmezoglu Shivaprasad S. Goudar
author_facet	Sumangala B. Chikkamath Geetanjali M. Katageri Ashalata A. Mallapur Sunil S. Vernekar Manjunath S. Somannavar Gilda Piaggio Guillermo Carroli José Ferreira de Carvalho Fernando Althabe G. Justus Hofmeyr Mariana Widmer Ahmet Metin Gulmezoglu Shivaprasad S. Goudar
author_sort	Sumangala B. Chikkamath
title	Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
title_short	Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
title_full	Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
title_fullStr	Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
title_full_unstemmed	Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data
title_sort	duration of third stage labour and postpartum blood loss: a secondary analysis of the who champion trial data
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b7d75c63f28c40fda75c7281d15df55b
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Duration of third stage labour and postpartum blood loss: a secondary analysis of the WHO CHAMPION trial data

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