NCT04401839

Amr Maneuver for Prevention of Postpartum Hemorrhage

Amr Maneuver for Prevention of Postpartum Hemorrhage After Vaginal Delivery in Term Women

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 306 (estimated)
• Sponsor: Cairo University · Academic / Other
• Sex: Female
• Age: 18 Years – 45 Years
• Healthy volunteers: Accepted

Summary

The patients were divided randomly in to 2 GROUPS: * control group: 153 patients received Oxytocin 10 IU I.V shot administered at the time of delivery of the anterior shoulder of the baby according to the WHO recommendation for both groups in prevention of postpartum haemorrhage,followed by active management of the third stage of labor by administration of oxytocin 5 IU units IM (WHO GDG recommendations,2012) and waiting for signs of placental separation then controlled cord traction (CCT)to the umbilical cord while applying simultaneous counter-pressure to the uterus, through the abdomen(Brandt Andrews maneuver) * study group:156 patients received Oxytocin 10 IU I.V shot at the time of delivery of the of the anterior shoulder of the baby according to the WHO recommendation .Then oxytocin is stopped and cervical traction (Amr maneuver )is applied.

Detailed description

The patients were divided randomly in to 2 GROUPS: * control group: 153 patients received Oxytocin 10 IU I.V shot administered at the time of delivery of the anterior shoulder of the baby according to the WHO recommendation for both groups in prevention of postpartum haemorrhage,followed by active management of the third stage of labor by administration of oxytocin 5 IU units IM (WHO GDG recommendations,2012) and waiting for signs of placental separation then controlled cord traction (CCT)to the umbilical cord while applying simultaneous counter-pressure to the uterus, through the abdomen(Brandt Andrews maneuver) * study group:156 patients received Oxytocin 10 IU I.V shot at the time of delivery of the of the anterior shoulder of the baby according to the WHO recommendation .Then oxytocin is stopped and cervical traction (Amr maneuver )is applied. In the maneuver,sustained traction downward and posteriorly was applied to anterior and posterior lips of the cervix using ovum forceps for approximately 90 seconds. The traction should be adequate to allow the cervix to reach the vaginal introitus. Meanwhile (CCT ) is avoided and watchful waiting for signs of placental separartion till 90 seconds end. Massage is not employed but the fundus is frequently palpaple to insure it doesnot become atonic and filled with blood from placenta separation. In cases whom placental separation did not occur within the 90 seconds, we removed the ovum forceps and waited for 30 min for the placental separation .

Conditions

• Post Partum Hemorrhage

Interventions

Type	Name	Description
DRUG	Oxytocin IV shot	Oxytocin 10 IU I.V shot administered at the time of delivery of the anterior shoulder of the baby
DRUG	Oxytocin IV drip	administration of oxytocin 5 IU units IM (WHO GDG recommendations,2012) and waiting for signs of placental separation
PROCEDURE	Amr maneuver	sustained traction downward and posteriorly was applied to anterior and posterior lips of the cervix using ovum forceps for approximately 90 seconds

Timeline

• Start date: 2020-05-31
• Primary completion: 2021-08-01
• Completion: 2021-09-01
• First posted: 2020-05-26
• Last updated: 2021-02-08

Locations

1 site across 1 country: Egypt