This research was conducted to study all the causes leading to postpartum hemorrhage in order to implement all the appropriate treatments, according to all reason and thus avoiding the complications of postpartum hemorrhage and death, and study of th
e risk of bleeding factors in order to reach the best method of prevention of bleeding . This research included on 77 patient acceptable in Al Assad University Hospital in Lattakia, with primary postpartum hemorrhage occurred after vaginal delivery, including (12) patient after vaginal birth outside the hospital, during the extended study period: from 1/1/2014 until 1/1 / 2016, and excluded all patients who were born cesarean delivery. We determine the percentage of postpartum hemorrhage occurring between vaginal deliveries in the hospital, and the ratio was (3.52%), and we could not determine this percentage outside the hospital.
The bleeding after delivery (Postpartum Hemorrhage-PPH) is the most important complications that occur after a natural or cesarean delivery, and represents about a quarter of maternal mortality around the world. Midwives play a basis role in preventi
on of bleeding after birth. So This research aims to evaluate the knowledge of midwives about using strategies to prevention and management the bleeding after delivery. Its sample included all midwives in obstetrics departments in Alasad University, Children and Obstetric, and Tishreen University Hospital all in Lattakia city. Data were collected using a questionnaire developed by researcher. The results according to strategies used in prevention and management of bleeding after delivery showed that 60% of the level of knowledge of midwives were "inappropriate". There were significant inverse relationship (P = 0.006) between ages of midwives and level of knowledge. Also showed a significant inverse relationship between number of years of experience with the midwives and level of knowledge (P = 0.01). So we suggest conducting training sessions and educational lectures for midwives with respect to the strategies used in prevention and management of bleeding after delivery, and must evaluate the midwives information about prevention and management of bleeding after delivery periodically and continuously.
Postpartum Hemorrhage (PPH) is the leading cause of maternal death worldwide. In the developing countries, it is responsible for the death of about 125 000 women each year. In most cases 67-80% are caused by uterine atony.
Uterine massage would re
present a simple intervention with the potential to have a major effect on PPH and maternal mortality in under resourced settings.
Aim: The aim of the present study is to study the effect of uterine massage on the immediate postpartum hemorrhage among primiparae.
Materials and Methods: The study was conducted of al-Assad Hospital and Children & Obstetrics Hospital (Lattakia), a convent sample of 40 primiparae women. Checklist application form was used to assess the postpartum hemorrhage by hemoglobin and hematocrit measurement before applying uterine massage and after the end of procedure.
Results: This study demonstrated that the rate of hemorrhage decreased in the experimental group, hemoglobin and hematocrit was higher (10.4 mg/dl, 32.3%) (P=0.029*) (P=0.015*) among primipara who received uterine massage.
Conclusions and Recommendations: Our present study results advice to apply uterine massage for all women after labor and delivery because its effective in reducing blood loss. It is also recommended to learn nurses how to apply uterine massage.
This search included 150 pregnant women who had gestational age of 36 weeks or more, and had been admitted to the Department of Obstetrics and Gynecology at Al – Assad University Hospital in Lattakia for the spontaneous vaginal delivery during the st
udy period
( 1\1\2012 to 1\7\ 2013). Exclusion criteria were patients undergoing cesarean section, patients with placenta previa, or abruptio placenta, patients with hemoglobin<9 gm%, pregnancy-induced hypertension or pre eclampsia–eclampsia, grand multiparty, coagulation abnormalities, positive history of PPH, expensive hemorrhage or other medical disorders.
Patients were randomly divided into three groups: ( 1: uterine massage group, 2: 10 units oxytocin in 500 cc glucose 5% intravenously with delivery of the anterior sholder\ control group, 3: three 200µg rectal misoprostol tablets\study group).
No significant differences were observed between the groups regarding baseline characteristics. There was blood loss of ≥500 ml occurred in 18% in the first group, 6% in the second group, 8% in the third group. Routine use of 600 µg of rectal misoprostol was effective in reducing blood loss after delivery ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g (RR 0.44 ; CI 0.32 – 1.53), but not as effective as intravenous oxytocin (RR 1.33 ; CI 0.4 – 3.39).
Although these were differences, they were not significant (No significant differences were observed between the control and study groups for the length of the third stage of labor, the estimated blood loss, the changes in Hb and Hct concentrations, need for additional uterotonics, manual removal of placenta, blood transfusion…..).
This dose of misoprostol and route of administration were well tolerated, and usual side effects such as shivering and fever were transient, resolved on their own, and were not threatening. Because PPH is the most significant direct cause of maternal mortality and because most of these maternal mortality occurs in low resource countries, misoprostol offers several advantages over oxytocin in such settings. It is formulated as a tablet, widely available and affordable, and it does not need require special storage conditions (i.e. it is stable at ambient room temperature and does not require specific conditions for transfer and has a shelf-life of several years). It also does not require any special skills, equipment, or facilities for its use. So misoprostol can fill a service delivery gap in settings where women and providers are unable to access oxytocin.ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g
This study was organized to find out the role and the efficacy of Misoprostol
in treating postpartum hemorrhage unresponsive to traditional agents that
contract the uterus .
Place : Maternity hospital at Faculty of Medicine in Damascus university
Time : from 2, January, 2004 to 2, January, 2005 .
Number of patients : 18 patients who met the criteria in that period of time .
Criteria of selection : any patient with post partum hemorrhage due to
uterine atony that did not respond well to the administration of Oxytocin
and Metergin .
Misoprostol is an effective treatment of post partum hemorrhage due to
uterine atony unresponsive to Oxytocin and Metergin.
Our study confirms the results of international studies of effectiveness of the
use of misoprostol in treating post partum hemorrhage due to uterine atony.
Late hemorrhagic disease of the newborn (HDN) is a rare complication of
vitamin-K deficiency and is especially associated with intracranial
hemorrhage (ICH). It may also occur in infants after the neonatal period.
This research aims to drive atten
tion to the late form of the hemorrhagic
disease of the newborn, secondary to vitamin K deficiency, as a cause of
intracranial hemorrhage in young infants, after the neonatal period.
A prospective study of 34 infants admitted on Pediatric Intensive Care Unit
and Children Hospital at Damascus University was conducted from January
2004 to December 2004. They were diagnosed as having Late HDN by the
Definite Criteria.
PIVH is the most common neonatal intracranial hemorrhage.
Incidence range between20-59% .Most of PIVH occur in the first week of
life. There are different opinions about the time of onset and timing of
screening. This study aimed to know incidence
, symptoms, classification,
predisposing factors and outcome of PIVH in our NICU, and the best time
of screening .
Placenta accreta is one of the most serious uncommon causes of
postpartum hemorrhage which carries high morbidity and mortality
risk for mother and fetus.
Objective
1- to assess the incidence of placenta accreta .
2- to ideNtify The occurrence o
f risk factors of placenta accreta :
maternal age , multiparity , placenta praevia, previous cesarean
section and/or previous curettage .
3- to find the ideal management of placenta accreta to reduce the risk of
maternal and neonatal morbidity and mortality .
