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Staff Training Reduces Postpartum Bleeding, Episiotomies
Date:4/30/2008

Studies urge oxytocin use after delivery, re-evaluation of accepted birthing practices

WEDNESDAY, April 30 (HealthDay News) -- An intensive educational program for physicians and midwives that stresses giving women the drug oxytocin just after a vaginal delivery resulted in significantly fewer cases of excessive bleeding, according to a study done in two South American countries.

Oxytocin helps contract the uterus and stop uterine bleeding. If the uterus fails to contract after detachment of the placenta, or ruptures or tears in the uterus and other tissues occur during birthing, postpartum hemorrhage can occur.

The education program, involving 19 hospitals in Argentina and in Uruguay, also resulted in fewer episiotomies being performed. While still a common procedure worldwide, many studies have shown that an episiotomy -- the surgical cutting of the skin between the vagina and anus -- is not beneficial in preventing tearing of the vagina during the birth process.

"It can be difficult to change accepted medical practices," Duane Alexander, director of the National Institutes of Health's Eunice Kennedy Shriver National Institute of Child Health and Human Development. "This successful intervention offers an effective model that can be translated into education programs suitable for interventions throughout the United States and Latin America."

The results of study were expected to be published in the May 1 issue of the New England Journal of Medicine.

The educational program sent up to six staff-selected "opinion leaders" at 10 public maternity hospitals in Argentina and Uruguay to a five-day workshop about developing and applying guidelines for physicians and midwives based on the best available scientific evidence. Instruction of techniques to hasten expulsion of the placenta and bring on uterine contractions that stop bleeding following detachment of the placenta were also taught.


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