The Impact of "Natural" Cesarean Delivery on Peripartum Maternal Blood Loss.

Raed Salim

Status: Completed

Conditions: Postpartum Hemorrhage

Treatments: Other: Natural cesarean delivery; Other: Standard cesarean delivery

Study type: Interventional

Funder types: Other

Identifiers

NCT02768142

00137-15-EMC

Details and patient eligibility

About

Throughout the history, the neonate was dependent on maternal touch and care for survival. In modern obstetrics, with hospital care the neonates are seldom separated from their mothers after delivery. Early skin to skin (ESTS) contact after delivery was found to increase milk production, lactation and improve maternal and neonatal outcome.

Oxytocin is the primary hormone responsible for uterine contraction and prevention of postpartum hemorrhage (PPH). ESTS contact increases oxytocin secretion.

The rate of cesarean deliveries (CDs) increased dramatically over the past decades. CD was found to decrease postpartum milk production, postpones early lactation and decreases exclusive breastfeeding.

During the typical CD, the neonate is usually presented for a short while to the mother and breastfeeding is usually delayed at least a number of hours until after the surgery and the recovery period.

Natural CD, enable ESTS contact during the surgery and give the mother the opportunity to start breastfeeding immediately after delivery of the neonate in the surgery suit. Oxytocin secretion increases with ESTS and during breastfeeding.

The aim of this study is to examine blood loss that occurs after Natural CD compared to standard CD without an ESTS contact.

Enrollment: 214 patients

Sex: Female

Ages: 8 to 45 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Estimated to be appropriate for gestational age fetus.
• Sonographic dating before 20 weeks of gestation.

Exclusion criteria

• Non-scheduled CD.
• Major fetal malformations.
• Multiple gestations.
• Non-controlled diabetes.
• Severe pre-eclampsia.
• General anesthesia.
• HIV carrier
• Neonatal need for early resuscitation.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

214 participants in 2 patient groups

Natural cesarean delivery

Experimental group

Description:

Placing the neonate on maternal chest immediately after the extraction from the uterus, and permitting breastfeeding during surgery.

Treatment:

Other: Natural cesarean delivery

Standard cesarean delivery

Active Comparator group

Description:

Presentation of the neonate to the mother during the operation.

Treatment:

Other: Standard cesarean delivery