Amr Maneuver for Prevention of Postpartum Hemorrhage

Last updated: February 5, 2021
Sponsor: Cairo University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Hemorrhage

Treatment

N/A

Clinical Study ID

NCT04401839
59
  • Ages 18-45
  • Female
  • Accepts Healthy Volunteers

Study Summary

The patients were divided randomly in to 2 GROUPS:

  • control group: 153 patients received Oxytocin 10 IU I.V shot administered at the time of delivery of the anterior shoulder of the baby according to the WHO recommendation for both groups in prevention of postpartum haemorrhage,followed by active management of the third stage of labor by administration of oxytocin 5 IU units IM (WHO GDG recommendations,2012) and waiting for signs of placental separation then controlled cord traction (CCT)to the umbilical cord while applying simultaneous counter-pressure to the uterus, through the abdomen(Brandt Andrews maneuver)

  • study group:156 patients received Oxytocin 10 IU I.V shot at the time of delivery of the of the anterior shoulder of the baby according to the WHO recommendation .Then oxytocin is stopped and cervical traction (Amr maneuver )is applied.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • women who candidate for vaginal delivery at casualty department singleton fetus fullterm pregnancy ( gestational age of more than 37 weeks).

Exclusion

Exclusion Criteria:

  • fetal macrosomia, any case with bleeding tendency e.g: haemorrhagic diseases caseswith risk of postpartum haemorrhage as: Peripartun hemorrhage ( placenta previa orplacental abruption), anemia or hypertension.

Study Design

Total Participants: 306
Study Start date:
May 31, 2020
Estimated Completion Date:
September 30, 2021

Study Description

The patients were divided randomly in to 2 GROUPS:

  • control group: 153 patients received Oxytocin 10 IU I.V shot administered at the time of delivery of the anterior shoulder of the baby according to the WHO recommendation for both groups in prevention of postpartum haemorrhage,followed by active management of the third stage of labor by administration of oxytocin 5 IU units IM (WHO GDG recommendations,2012) and waiting for signs of placental separation then controlled cord traction (CCT)to the umbilical cord while applying simultaneous counter-pressure to the uterus, through the abdomen(Brandt Andrews maneuver)

  • study group:156 patients received Oxytocin 10 IU I.V shot at the time of delivery of the of the anterior shoulder of the baby according to the WHO recommendation .Then oxytocin is stopped and cervical traction (Amr maneuver )is applied.

In the maneuver,sustained traction downward and posteriorly was applied to anterior and posterior lips of the cervix using ovum forceps for approximately 90 seconds. The traction should be adequate to allow the cervix to reach the vaginal introitus. Meanwhile (CCT ) is avoided and watchful waiting for signs of placental separartion till 90 seconds end. Massage is not employed but the fundus is frequently palpaple to insure it doesnot become atonic and filled with blood from placenta separation. In cases whom placental separation did not occur within the 90 seconds, we removed the ovum forceps and waited for 30 min for the placental separation .

Connect with a study center

  • Kasr Alainy medical school

    Cairo, 12151
    Egypt

    Active - Recruiting

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