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[Postpartum hemorrhage--prophylaxis and treatment in Norway]
Ashild Bjørnerem1, Ganesh Acharya, Pål Øian
1Kvinneklinikken Universitetssykehuset Nord-Norge 9038 Tromsø. ashild.bjornerem@ism.uit.no
Background:
Routine oxytocic prophylaxis is known to significantly reduce the risk of severe postpartum haemorrhage (> 1,000 ml) and need for blood transfusion after delivery. To what extent this evidence is implemented in clinical practice in Norway is not known.
Material And Methods:
A telephone questionnaire survey was carried out in September 2001 to evaluate the routine clinical practice for prevention and treatment of postpartum haemorrhage in Norwegian delivery units.
Results:
Data were available for 55 out of 57 institutions with a delivery unit. Routine third stage prophylaxis with 5-10 IU oxytocin was practiced in 47% of delivery units. Intravenous oxytocin infusion was used primarily in all the delivery units for the treatment of established primary postpartum haemorrhage. 74% of units used methylergometrine, 21% misoprostol as the second-line treatment.
Interpretation:
Despite evidence for the use of oxytocics for the prevention of postpartum haemorrhage, less than half of delivery units in Norway practice routine prophylaxis in the third stage of labour. Norwegian women may benefit if all maternity care providers implement evidence-based practice.