Effect of Clinical Pathway on Preventing of Postpartum Hemorrhage during Fourth Stage of Labor / Asmaa Abdelatef Aboelhaded ; Supervised Abeer Saad Zaghloul Eswi , Hanan Fahmy Azzam

Thesis (M.Sc.) - Cairo University - Faculty of Nursing - Department of Maternal and Newborn Health Nursing

Postpartum hemorrhage (PPH) is a major cause of maternal mortality and severe morbidity all over the world especially in developing countries. It causes (25%) of maternal death. Aim of the study was to evaluate the effect of clinical pathway on preventing postpartum hemorrhage during fourth stage of labor. A Quasi-experimental design (non-equivalent groups) was utilized. This study was carried out at the delivery and postpartum unit in Maternity and Gynecological Hospital at Cairo University Hospital. A total of (360) women were recruited immediately after delivery during fourth stage of labor with inclusion criteria. Three tools were utilized to collect data: 1) demographic and obstetrical data tool, 2) postpartum maternal assessment tool and, 3) postpartum follow up assessment tool. Results show that, there was a statistical significant difference between the study and control groups regarding to uterine condition which revealed (98%, & 94.4% respectively) had firmed uterus. (98%, & 94.4% respectively) in the study & control group had moderate amount of lochia with total mean (242.5±53, 302± 33.1respectively), (95%, 85%) of women in the study & control groups discharged within 6hrs after delivery. It was concluded that, women who received the designed nursing clinical pathway were less likely to develop PPH than those who exposed to the routine hospital care, this improvement was obvious in relation to the amount of blood loss, stability in vital sign, improvement in uterine condition and consistency, and shortened length of hospital stay. Based on the study findings, the following was recommended: Postpartum hemorrhage clinical pathway and protocols should be applied and used in maternity hospital.

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