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Factors contributing to postpartum blood-loss in low-risk mothers through expectant management in Japanese birth centres


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タイトル: Factors contributing to postpartum blood-loss in low-risk mothers through expectant management in Japanese birth centres
著者: Eto, Hiromi / Hasegawa, Ayako / Kataoka, Yaeko / Porter, Sarah E.
発行日: 2017年
出版者: Australian College of Midwives
引用: Women and Birth, 30(4), pp.e158-e164; 2017
抄録: Objective: To describe aspects of expectant midwifery care for low-risk women conducted in midwifery-managed birth centres during the first two critical hours after delivery and to compare differences between midwifery care, client factors and postpartum blood loss volume. Method: As a secondary analysis from a larger study, this descriptive retrospective study examined data from birth records of 4051 women who birthed from 2001 to 2006 at nine (21%) of the 43 midwifery centres in Tokyo. Nonparametric and parametric analyses identified factors related to increased blood loss. Interviews to establish sequence of midwifery care were conducted. Findings: The midwifery centres provided care based on expectant management principles from birth to after expulsion of the placenta. Approximately 63.3% of women were within the normal limits of blood loss volume under 500. g. A minority of women (12.9%) experienced blood loss between 500 and 800. g and 4% had blood loss exceeding 1000. g. Blood loss volume tended to increase with infant birth weight and duration of delivery. The total blood loss volume was significantly higher for primiparas than for multiparas during the critical two hours after delivery and for immediately after delivery, yet blood loss volume was significantly higher for multiparas than for primiparas during the first hour after delivery. Preventive uterine massage and umbilical cord clamping after placenta expulsion resulted in statistically significant less blood loss. Identified were two patterns of midwifery care based on expectant management principles from birth to after expulsion of the placenta. The practice of expectant management was not a significant factor for increased postpartum blood loss. Conclusion: These results detail specific midwifery practices and highlight the clinical significance of expectant management with low risk pregnant women experiencing a normal delivery.
キーワード: Birth homes / Expectant management / Midwives / Post-partum blood loss / Postpartum haemorrhage
URI: http://hdl.handle.net/10069/37765
ISSN: 18715192
DOI: 10.1016/j.wombi.2016.11.003
権利: © 2017 Australian College of Midwives. Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
資料タイプ: Journal Article
原稿種類: author
出現コレクション:030 学術雑誌論文

引用URI : http://hdl.handle.net/10069/37765

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