Reminder systems for self uterine massage in the prevention of postpartum blood loss: A Proof of Concept Study.

Abstract

Background: Uterine massage may significantly reduce post partum blood loss and could be patient-driven. Objective: To assess the effectiveness of an alarm reminder system for self uterine massage in the prevention of post partum blood loss. Setting: Meru District Hospital, Kenya. Methods: A randomized control trial was undertaken. One hundred and twenty seven (127) were randomly assigned to a 15 minute alarm reminder system (71) and non-alarm (56) control arm during the fourth stage of labour. All women self supervised their uterine massage after prior training. The primary outcome measure was the amount of blood loss within the first 2 hours post delivery. Other outcome measures included vital signs during the observation period, frequency of massage and need for blood transfusion. Results: Uterine massage compliance was better in the alarm group compared to the non-alarm group ( Average massage of 7 and 2 in two hours respectively P <0.0001) ,however the difference in blood loss was not significant 45.6 ml (95% CI 43-46) vs 47.1 ml (95% CI 43-52)ml p-value 0.892 Conclusion: Uterine massage compliance is remarkably increased by the use of an alarm reminder.