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Re: Active management - third stage From: Robert J. Carpenter, Jr. MD (zygote@icsi.net) Wed Oct 12 06:23:58 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Anna Meenan, MD: "Re: 50 yo & contraception" Previous message: Marie Harkins: "Re: 50 yo & contraception" In reply to: GA12L@aol.com: "Re: Active management - third stage" Next in thread: Efrain Ramirez: "Re: Active management - third stage" Reply: Efrain Ramirez: "Re: Active management - third stage" Reply: rmodugno@aol.com: "Re: Active management - third stage" The active management of third stage actually has a controilled prospective trial in England 12-15 years (or perhaps more now) and it had minimal downside. The blood loss was documented to be less. I'm sure for those who have access to Cochran you can pull it without difficulty. RJC On 12 Oct 2005 at 3:39, GA12L@aol.com wrote: > I used to work in a birth centre which was run by midwives only. We > always did physiological third stage unless the woman asked for > syntometrine (very few did). Part of our exclusion criteria was an > HB lower than 10 so none of our women were anaemic. This is what we > saw, admittedly it was only just over 400 women. > > Firstly, yes they bled heavily to begin with but that stooped within > 30 mins and then their blood loss was minimal. I have noticed in > women who have syntometrine that once the action wears off the > bleeding becomes heavier. Swings and roundabouts... > > Secondly, multips either had very mild or no afterpains. > > I have a problem with the term PPH. A woman who has an HB of 13 and > looses 600 mls is in a better position than a woman who has an HB of > 9.5 and looses 400 mils. Technically the first woman has had the PPH > but women with a good HB can lose a 1000mls and still not suffer any > ill effects. > > I now work in a hospital and unless the situation indicates I don't do > active management of the 3rd stage. The only PPH's I have seen have > been on women who have had syntometrine. If a woman's body is > capable of birthing her baby without any intervention why can't it > deliver the placenta the same way, without intervention. > > Syntometrine causes a woman's BP to rise and makes her feel nauseous > and can make her actually vomit does pitocin do the same? > > Gail > -- Robert J. Carpenter, Jr. MD 6624 Fannin, #2720 St. Luke's Medical Tower Houston,TX 77030-2339 713-795-4600 Next message: Anna Meenan, MD: "Re: 50 yo & contraception" Previous message: Marie Harkins: "Re: 50 yo & contraception" In reply to: GA12L@aol.com: "Re: Active management - third stage" Next in thread: Efrain Ramirez: "Re: Active management - third stage" Reply: Efrain Ramirez: "Re: Active management - third stage" Reply: rmodugno@aol.com: "Re: Active management - third stage"

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