The impact of cervical traction (Amr Maneuver) with passive management of third stage of labor in prevention of post partum hemorrhage, compared to active management : Randomized Control Study / Marwa Ali Ali Abdelraheem ; Supervised Ali Abdelhafeez Abdellatif , Marwa Fouad Sharaf

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Obstetrics and Gynecology

Objectives: to assess the impact of cervical traction maneuver (Amr{u2019}s maneuver)along with passive management of third stage of labor on incidence of post partum hemorrhage (PPH) aiming to decrease the need for oxytocin in limited resources maternity places in comparison to active management of third stage of labor (AMTSL).Method: the present randomized controlled trial was conducted in Kasr Alainy hospital between October 2019 to April2020.Women aged at least 18 years who had singleton pregnancies and were candidates for vaginal delivery .After block randomization 309 patients were divided into control and study groups. In the study group,Amr{u2019}s maneuver, using cervical traction for 90 seconds before delivery of the placenta along with passive management of third stage of labor was carried out (AMTSL) was used in control group. The primary outcome, was the incidence of primary (PPH) (>500ml blood loss) within 6 hours of delivery,was compared between study and control groups and to assess thedifferent hematological parameters in both groups.Results:There were 309 patients randomized to the study (n=156) and control (n=153) groups.Incidence of post partum hemorrhage was 8 (5.1%) in case group versus 5 (3.3%)in control group which was statistically not significant. Calculated blood loss was lower in the study group(270±236ml )compared to control group(277.8±134.3ml). However, reduction of HB &HCT level,was more in study group compared to the control group(0.83±0.75)vs. (0.78±0.14),for HB and (2.46±2.01) vs.(2.35±0.44)for HCT,but this difference was statistically not significant

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