Document Detail


Two-provider technique for bimanual uterine compression to control postpartum hemorrhage.
MedLine Citation:
PMID:  22758359     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Introduction: Bimanual uterine compression may provide a reasonable treatment option for controlling or arresting postpartum hemorrhage in areas where access to care and advanced medical interventions are limited. Preliminary evidence suggests that correctly performed bimanual uterine compression is unsustainable for more than a few minutes, despite empirical evidence and practice recommendations that support extended compression for optimal effect. The objective of this study was to examine the impact of team-based (pairs) bimanual uterine compression for managing postpartum hemorrhage from uterine atony. Methods: Obstetricians, nurse-midwives, midwifery students, and unskilled birth attendants (N = 30) in Ghana performed bimanual uterine compression using a simulator with objective performance feedback (6 lights) corresponding to pressure sensors on the uterus. For each participant, we tracked the degree and duration of maintained uterine compression. Birth attendants were then paired (15 pairs) and were similarly assessed performing the technique as a team, with 1 attendant providing external compression to the uterine fundus using 2 hands and the other providing internal pressure against the body of the uterus with a single hand. Results: Individuals were unable to fully compress the uterus and maintain compression for more than 150 seconds without fatiguing. All paired teams were able to fully compress the uterus and maintain the compression for the maximum allotted time of 5 minutes. Discussion: Results suggest that bimanual uterine compression is more effective when performed by a team, with a primary attendant maintaining internal lower uterine segment pressure and monitoring the patient's condition and a partner applying external pressure to the uterine fundus. For cases where access to advanced medical care is limited or delayed, team-applied bimanual uterine compression could enhance the ability to control or arrest postpartum hemorrhage and increase the likelihood of maternal survival.
Authors:
Pamela Andreatta; Joseph Perosky; Timothy R B Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of midwifery & women's health     Volume:  57     ISSN:  1542-2011     ISO Abbreviation:  J Midwifery Womens Health     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909407     Medline TA:  J Midwifery Womens Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  371-5     Citation Subset:  IM; N    
Copyright Information:
© 2012 by the American College of Nurse-Midwives.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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