{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T06:44:32Z","timestamp":1695624272880},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,9,5]],"date-time":"2016-09-05T00:00:00Z","timestamp":1473033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Postpartum haemorrhage (<jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content>) rates are increasing worldwide. The rate is particularly high in women undergoing an induced or augmented labour. In response to this, we altered our hospital's protocol for the management of the third stage of labour to recommend Syntometrine, in preference to oxytocin alone, for women being induced or augmented. We set out to assess the impact of the protocol change on the <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A random sample of 1200 women who had a singleton, term vaginal birth before and after the protocol change was taken. Exclusion criteria were then applied to match <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> risk status. Using a quasi\u2010experimental study design, <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rates were compared between women who had received oxytocin or Syntometrine for third stage management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five hundred and forty\u2010nine women received oxytocin prior to the protocol change and were compared with 333 women who received Syntometrine after protocol change. There was no difference in the <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rate with respect to uterotonic used (<jats:italic>P<\/jats:italic> = 0.9). There was no evidence of an interaction between labour type, third stage uterotonic and <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> (<jats:italic>P<\/jats:italic> = 0.4). <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rates were lowest for women who laboured spontaneously and received Syntometrine (19% oxytocin, 14% Syntometrine). The <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rate was unchanged by uterotonic in women whose labour was augmented (34% for both). <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> was more common in women being induced who received Syntometrine (22% oxytocin, 27% Syntometrine). None of these differences were statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared to oxytocin, Syntometrine did not reduce the rate of <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> in women with augmented or induced labour. Other approaches to reducing <jats:styled-content style=\"fixed-case\">PPH<\/jats:styled-content> rates are required.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12517","type":"journal-article","created":{"date-parts":[[2016,9,5]],"date-time":"2016-09-05T09:53:40Z","timestamp":1473069220000},"page":"302-307","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Customised management of the third stage of labour"],"prefix":"10.1111","volume":"57","author":[{"given":"Edward","family":"Springhall","sequence":"first","affiliation":[{"name":"Monash Women's Services Monash Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Euan M.","family":"Wallace","sequence":"additional","affiliation":[{"name":"Monash Women's Services Monash Health Melbourne Victoria Australia"},{"name":"The Ritchie Centre The Hudson Institute of Medical Research Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynne","family":"Stewart","sequence":"additional","affiliation":[{"name":"Monash Women's Services Monash Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Knight","sequence":"additional","affiliation":[{"name":"Monash Women's Services Monash Health Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne C.","family":"Mockler","sequence":"additional","affiliation":[{"name":"Monash Women's Services Monash Health Melbourne Victoria Australia"},{"name":"The Ritchie Centre The Hudson Institute of Medical Research Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda","family":"Davies\u2010Tuck","sequence":"additional","affiliation":[{"name":"The Ritchie Centre The Hudson Institute of Medical Research Melbourne Victoria Australia"},{"name":"Department of Obstetrics and Gynaecology Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,9,5]]},"reference":[{"key":"e_1_2_5_2_1","unstructured":"WHO recommendations for the prevention and treatment of postpartum haemorrhage.Geneva:World Health Organization 2012. [Cited 7 August 2016]. Available from URL:http:\/\/www.who.int\/reproductivehealth\/publications\/maternal_perinatal_health\/9789241548502\/en\/."},{"key":"e_1_2_5_3_1","unstructured":"World Health Organization.Managing complications in pregnancy and childbirth: A guide for midwives and doctors.Geneva:World Health Organization 2000. [Cited 7 August 2016]. Available from URL:http:\/\/www.who.int\/maternal_child_adolescent\/documents\/9241545879\/en\/."},{"key":"e_1_2_5_4_1","unstructured":"AIHW:JohnsonS BonelloMR LiZet al.Maternal deaths in Australia 2006\u20132010 Maternal deaths series no. 4. Cat. no. PER 61.Canberra:AIHW 2014."},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000201.pub2"},{"key":"e_1_2_5_6_1","unstructured":"The Royal College of Obstetricians and Gynaecologists (RCOG).Postpartum Haemorrhage Prevention and Management (Green Top Guideline No. 52)[Internet].London UK:RCOG 2009[updated 2011 Apr; cited 19 August 2015.] Available from URL:https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/gtg52\/."},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-9-55"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12636"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-015-3771-5"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0054858"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-2760(03)00080-8"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.08.023"},{"key":"e_1_2_5_13_1","unstructured":"Three Centres Collaboration. 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