An American study revealed that there are two simple solutions that can help prevent severe bleeding (postpartum bleeding) after a cesarean section.
In a study presented at the Annual Anesthesia Meeting in San Francisco on Saturday, researchers explained that postpartum hemorrhage is the leading cause of maternal death in the United States at the time of childbirth, and is more common after cesarean section than vaginal deliveries.
Both solutions aim to treat a condition called “uterine atony” or laxity of the uterus. It is a condition that makes the uterus weak after birth and does not contract to put pressure on the blood vessels connected to the placenta, and causes up to 80 percent of postpartum hemorrhage cases, according to the study.
One solution is to inject medication to help the uterus contract after birth. The other is an early warning system that prompts doctors to assess the extent of uterine contraction after birth, by manually examining it. To quickly alert the health care team when a woman is at risk of severe bleeding and requires treatment.
The researchers arrived at the results after a randomized trial on 120 women who needed a cesarean section after labor. They were given “oxytocin” injections, which increase uterine contraction during labor, which exposes them to a much greater risk of suffering from “uterine atony” and postpartum bleeding.
The researchers gave half of the participants an injection of 1 gram of calcium chloride, while the other half received a placebo.
According to the researchers, calcium chloride injections are an inexpensive, simple, and safe drug to stop obstetric bleeding. It does not require refrigeration like other treatments, and therefore can be used even in low-resource settings.
Globally, a new mother dies from postpartum hemorrhage approximately every 7 minutes, and most cases are in low-resource settings, according to the study.
Among the women who received the placebo, 57 percent of them had postpartum hemorrhage and 15 percent needed a blood transfusion, while 40 percent of those who received calcium chloride injections had bleeding, and 8.3 percent of them needed a blood transfusion.
The results showed that calcium chloride reduced the amount of bleeding during cesarean section by approximately a cup (more than 200 milliliters).
“There is an urgent need for new medications to treat uterine atony,” said Dr. Alla Jarmusch, an assistant professor of anesthesiology at Stanford University and the study’s lead researcher.
She added, “This is the first time that the effect of calcium chloride injections has been studied as a potential treatment to help the uterus contract after a cesarean section and reduce bleeding.”
She pointed out that if their findings are confirmed by larger studies, it will be easy for health institutions to implement them, as anesthesiologists regularly perform injections during surgery.
