Tehran University Medical Journal

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Post partum haemorrhage (PPH) and retained placenta are the most common serious abnormalities encountered during the third stage of labour. PPH is one of the most common causes of mortality in childbirth, particularly in developing countries. The incidences of PPH and retained placenta have decreased with the use of synthetic oxytocin and controlled cord traction (CCT). Weather such treatment is valuable is open to question because of the lack of clinical and physiological studies. Unfortunately, oxytocic drugs are not available to about half the women of developing countries, who do not deliver under the care of a trained midwife. We know that sucking stimulates uterine contractions in lactating women. This effect is probably mediated by the high plasma oxytocin levels that occur during preparations for breast-feeding and again within 3 min of the start of sucking. Traditional birth attendants (TBAs) do not have the skill to administer injectable oxytoxics. It has become the practice in some TBA training programmes to teach that the risk of PPH can be reduced if the mother puts her baby to the breast immediately after delivery. Objective: To determine the effect of sucking immediately after childbirth on the length of 3rh stage and amount of bleeding in the first day. This is a semi-experimental study. It was done in Tehran'e Mirzakochak hospital. 100 women received oxytocin intramuscularly and 120 women were placed in sucking group. Then the lenghth of 3rd stage and amount of bleeding in the first day was compared between two groups. Results: The duration of the third stage and number of pads different between oxytocin group and sucking group (4.42 vs 6.08 min) and (10.58 vs 11.72 number). As for the, parity, gestational age, maternal systolic and diastolic blood pressure, infant weight and hight, the results showed no significant difference between the groups. As for the, maternal age, the results showed differed significantly between the groups. As for the gestational age, the results of the research showed that between the gestational age and the duration of the third stage, there was a reverse correlation in multipare women. So when gestational age decreases the duration of third stage will be longer. As for the maternal age, parity, systolic and diastolic blood pressure, infant weight, infant hight, infant sex, the results showed that there was no correlation between these and the duration of the third stage.

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Background: The aim of this study was to statistically evaluate the hypothesis that the presence of meconium-stained amniotic fluid is associated with postpartum maternal infection.
Methods: This prospective cohort study included 573 term pregnant women in labor, with no other medical problems, that underwent cesarean section for pregnancy termination. Women with prolonged active-phase labor, prolonged rupture of membranes, complicated cesarean section and pre-operative infections were excluded from this study.
The subjects were divided into two groups: 280 women with meconium-stained amniotic fluid (M group), and 293 women with clear amniotic fluid (C group). A comparison was done regarding postpartum fever, endometritis and wound infection between the two groups. Student's t-test and chi square test were used for data analysis, along with linear regression, with p<0.05 indicating significance.
Results: Among the 573 women, a total of 82 women (14%) had fever after cesarean 42 women from the M group, and 40 women from the C group (p= 0.3). Among the 82 women who had fever, 33 women had continuous fever, 6.5% in group M and 2.7% in group C (p<0.05, RR: 1.98, 95% CI 1.3-3.1). Among the 573 women, 4% developed endometritis 5% in group M and 2% in group C (p<0.05, RR: 2.3, 95%, CI 1.3-3.4). Similarly, among the 573 women, a total of 5 women (1%) developed wound infection, 1.7% in group M and 0.68% in group C (p=0.7).
Conclusion: Meconium-stained amniotic fluid is associated with increased postpartum infection independent of other risk factors for infection.