WE had
a CARES member once who had PPH with all of her babes and all were actively
managed. She then read in Effective Guide that active management can
in fact cause PPH in some cases.
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Emily
Sent: Friday, November 18, 2005 9:26 AM
To: [email protected]
Subject: [ozmidwifery] PPH riskshi everyone
does anyone know of any evidence on the volume of PPHs averted by active management? the big studies 'show' (whether flawed or not) that active management decreases the risk of PPH, but id like to know how much of this decrease is in the minor PPH range 500mL-1000mL which isnt likely to be symptomatic or adversely affect the woman anyway.
another thing i find amazing is that physiological management 'isnt allowed' because of the increased risk of PPH, yet an emergency caesarean is associated with a 9 times increased risk of PPH !! and elective caesarean with a 4 times increased risk. an episiotomy is associated with a 5 times increased risk. yet these are never used as reasons why we shouldnt use such interventions. it is just accepted as part of the process. but any risk associated with leaving things alone is seen as unacceptable
(reference http://www.show.scot.nhs.uk/sign/guidelines/sogap/sogap4.html)!
:(
emily
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