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Title: Afterpains- a comparison between active and expectant management of the third stage of labour
Authors: Jangsten, Elisabeth
Bergh, Ingrid
Mattsson, Lars-Åke
Hellström, Anna-lena
Berg, Marie
Department: Other
Issue Date: 2011
Journal Title: Birth
ISSN: 0730-7659
Volume: 38
Issue: 4
Pages: 294-301
Publisher: Wiley Periodicals, Inc
Media type: text
Publication type: article, peer reviewed scientific
Keywords: third stage of labour
childbirth
Subject Category: Subject categories::Medical and Health Sciences
Subject categories::Social Sciences Interdisciplinary::Nursing
Area of Research: Midwifery
Strategic Research Area: none
Abstract: ABSTRACT: Background: Management of the third stage of labor, the period following thebirth of the infant until delivery of the placenta, is crucial. Active management using synthetic oxytocin has been advocated to decrease blood loss. It has been suggested, but not studied, thatoxytocin may increase afterpains. The aim of this study was to compare women’s experience of pain intensity when the third stage of labor was managed actively and expectantly and their experience of afterpains. Methods: A single-blind, randomized, controlled trial was performed at two delivery units in Sweden in a population of healthy women with normal, singleton pregnancies, gestational age of 34 to 43 weeks, cephalic presentation, and expected vaginal delivery. Women (n = 1,802) were randomly allocated to either active management or expectant management of the third stage of labor. Afterpains were assessed by Visual Analog Scale(VAS) and the Pain-o-Meter (POM-WDS) 2 hours after delivery of the placenta and the day after childbirth. Results: At 2 hours after childbirth, women in the actively managed group had lower VAS pain scores than expectantly managed women (p = 0.014). Afterpains were scored as more intense the day after, compared with 2 hours after, childbirth in both groups. Multiparas scored more intense afterpains, compared with primiparas, irrespective of management(p < 0.001). Conclusions: Active management of the third stage of labor does not provoke more intense afterpains than expectant management.
DOI: 10.1111/j.1523-536X.2011.00487.x
URI: http://hdl.handle.net/2320/10066
Appears in Collections:Artiklar och rapporter / Articles and reports (EX)

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