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Termination and Contraceptive Options for the Cardiac Patient
Published in Afshan B. Hameed, Diana S. Wolfe, Cardio-Obstetrics, 2020
For these patients, the surgeon may consider uterine massage or prophylactic agents to prevent hemorrhage like misoprostol or methylergonovine [86]. Some providers may still briefly stop anticoagulation or transition to heparin [67]. Decisions regarding continuation or interruption of anticoagulation should be in conjunction with the multidisciplinary team, the heart team, including cardiology, and anesthesia. Low dose unfractionated heparin (e.g., 5000 units subcutaneously every 8 hours) or low molecular weight heparin (e.g., enoxaparin 40 mg subcutaneously daily) can be considered for those taking a recess from therapeutic anticoagulation.
Haemorrhage
Published in Daryl Dob, Griselda Cooper, Anita Holdcroft, Philip Steer, Gwyneth Lewis, Crises in Childbirth Why Mothers Survive, 2018
These may be of value in reducing haemorrhage. Uterine massage often stimulates contraction, and may be the only treatment required for mild uterine atony. If this fails, pressure on the uterine placental bed may reduce haemorrhage and be a useful holding measure until definitive treatment can be given. This can be achieved by bimanual compression of the uterus, or using a balloon compression device inserted into the uterus, such as a Cook’s catheter. Reducing the blood flow to the uterus by aortic compression is also an option. This is achieved using a fist above the umbilicus directed backwards against the spine.
Obstetric Hemorrhage II: Postpartum Hemorrhage
Published in Lauren A. Plante, Expecting Trouble, 2018
Amanda Flicker, Casey Brown, John C. Smulian
Randomized trials suggest that the uterotonic agent is the most important component of AMTSL and can reduce postpartum blood loss (10). The value of aggressive uterine massage may be less than has been historically assumed.
Low-intensity ultrasound promotes uterine involution after cesarean section: the first multicenter, randomized, controlled clinical trial
Published in International Journal of Hyperthermia, 2022
Yi Qin, Xiaobo Zhao, Xiaojing Dong, Juntao Liu, Longqiong Wang, Xiaohua Wu, Bin Peng, Chengzhi Li
It is clinically suggested that uterine massage can be used to stimulate uterine contractions [9], indicating that mechanical stimulation can effectively promote uterine smooth muscle contraction. We can use the mechanical effect of low-intensity ultrasound to stimulate uterine contractions, thus avoiding the inconsistencies and irregularities in the timing, speed, force and technique of manual uterine massage. The contraction of the uterus is not as strong as in vaginal deliveries due to injury, so it is even more important to take active and effective measures to restore the uterus in women who have had a cesarean section.