Two easy fixes could reduce bleeding after cesarean delivery (Calcium chloride & uterine tone checks)

Medical Xpress / Am Soc of Anesthesiologists / ANESTHESIOLOGY 2023 annual meeting ^ | Oct. 14, 2023 | James Xie, M.D. et al

[ConservativeMind]

Two simple solutions could help prevent severe bleeding (postpartum hemorrhage) after cesarean delivery, suggests research.

Both solutions help address uterine atony, which causes up to 80% of postpartum hemorrhage. Uterine atony is when, after delivery, the uterus remains soft and weak.

The researchers found that calcium chloride reduced the amount of bleeding that patients experienced during their cesarean delivery by nearly a measuring cup (more than 200 mL).

The double-blind, randomized, controlled trial included 120 women who required a cesarean delivery after labor with an oxytocin infusion (which increases contraction of the uterus during labor), placing them at much higher risk of suffering from uterine atony and bleeding after the birth. Researchers randomly assigned 60 women to receive 1-gram infusions of calcium chloride and 60 women to receive a placebo.

Of the women who received the placebo, 57% had postpartum hemorrhage and 15% required a blood transfusion, while 40% of those who received calcium chloride had postpartum hemorrhage and 8.3% required a blood transfusion.

For the early warning study, researchers created an alert that pops up on the anesthesiologist's electronic health record (EHR) module, asking for a uterine score from 1–10. The anesthesiologist prompts the obstetrician to assess the uterine tone (by manually feeling it) and provide the score. Scores of 6 or lower mean the uterus is not contracting well and the woman is at higher risk for postpartum hemorrhage.

The study assessed more than 1,000 consecutive cesarean deliveries by 70 different obstetricians over eight months. The uterine tone score was assessed three times for each patient.

At 12 minutes, 179 women (18%) had scores of 6 or lower, meaning they were at higher risk for severe bleeding. Of those with scores of 6 or lower, 77% experienced hemorrhage, 46% experienced major hemorrhage and 25% needed a blood transfusion.

[ConservativeMind]

Some simple tweaks could prevent postpartum hemorrhages from going out of control.

[ConservativeMind]

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[sasquatch]

Confusing. I use calcium chloride as a desiccant to keep things dry.???

[heartwood]

I know a young woman who was just treated with a JADA device, a vacuum balloon, when her uterus went atonic and she began to hemorrhage after a vaginal birth.

It causes rapid contracting of the uterus and blood vessels, and holds the negative pressure until the uterus catches up. Brilliant simplicity, relatively low tech. Can be used in hospitals in developing countries.

https://www.thejadasystem.com/