Dear Emily,
I think the research does not quite say that it
reduces PPH's but reduces the overall blood loss, especially if there is a PPH
i.e. instead of loosing 1000mls you may only loose 700mls but an active third
stage it does not prevent a PPH.
Regards Anne Clarke Queensland
----- Original Message -----
Sent: Friday, November 18, 2005 8:56
AM
Subject: [ozmidwifery] PPH risks
hi 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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