The Effect of Inhaled Oxygen on Postpartum Hemorrhage: A Systematic Review and Meta Analysis

Elaheh Mansourie Ghezelhesari1,, Sedigheh Abdollahpour, Seyed Javad Hosseini, Bibi Lelila Hoseini, Atefeh Yas, Ezat Hajmolarezaei, Talat Khadivzadeh

Abstract


Background: Postpartum Hemorrhage (PPH) is a significant problem that can increase the risk of maternal mortality. Previous studies investigated the effect of Inhaled Oxygen (IO) on PPH. They found some conflicting results. Thus, the current systematic review and meta‑analysis aimed to determine the effect of IO on PPH.

Materials and Methods: Randomized trials were searched according to the PRISMA framework until the end of November 2022 in Web of Science, PubMed, Scopus, and Cochrane Library databases. Statistical analyses were performed in the STATA v. 14 software. I2 statistic was applied to assess heterogeneity between studies. The random effect model, sample size, and mean and standard deviation of each group were applied to report the pooled effect size. Version 2 of the Cochrane risk‑of‑bias tool for randomized trials (RoB 2) was used to evaluate the risk of bias in the included studies. Finally, five articles were included in the meta‑analysis. Two and three studies reported the mean of bleeding after vaginal delivery during one‑ and two‑hours oxygen therapy, respectively.

Results: Results showed that IO significantly reduced bleeding by 38.91 mL in the intervention group compared to routine care (WMD: −38.91, 95%CI: −60.18 to −17.64) after vaginal delivery. In addition, IO during one (WMD: −38.42, 95%CI: −71.62 to −5.22) and two (WMD: −41.93, 95%CI: −60.15 to − 23.71) hours significantly decreased bleeding in the intervention.

Conclusion: According to the present study, IO can significantly reduce PPH in the intervention group compared to routine care. However, more rigorously randomized clinical trials are required to decide better about this issue.



Keywords


Meta‑analysis, oxygen inhalation therapy, postpartum hemorrhage, systematic review, uterine hemorrhage, vaginal bleeding

Full Text:

PDF

References


Jin X H, Li D, Li X. Carbetocin vs oxytocin for prevention of postpartum hemorrhage after vaginal delivery: A meta analysis. Medicine (Baltimore) 2019;98:e17911.

Amanuel T, Dache A, Dona A. Postpartum hemorrhage and its associated factors among women who gave birth at Yirgalem General Hospital, Sidama Regional State, Ethiopia. Health Serv Res Manag Epidemiol 2021;8:23 9.

Abdollahpour S, Heydari A, Ebrahimipour H, Faridhoseini F, Khadivzadeh T. Death stricken survivor mother: The lived experience of near miss mothers. Reprod Health 2022;19:5.

Abdollahpour S, Heydari A, Ebrahimipour H, Faridhoseini F, Khadivzadeh T. Mothering sweetness mixed with the bitterness of death: The lived mothering experience of near miss mothers. J Psychosom Obstet Gynecol 2022;43:128 35.

Feduniw S, Warzecha D, Szymusik I, Wielgos M. Epidemiology, prevention and management of early postpartum hemorrhage—A systematic review. Ginekol Pol 2020;91:38 44.

Khojastehfard Z, Golmakani N, Mazloum SR, Hamedi SS, Feyzabadi Z, Mirteimouri M. The effect of plantago major rectal suppository on postpartum hemorrhage rate in women at the risk of bleeding: A single blind clinical trial. Iran J Obstet Gynecol Infertil 2019;22:58 65.

Abdollahpour S, Heydari A, Ebrahimipour H, Faridhosseini F,Khadivzadeh T. The needs of women who have experienced “maternal near miss “: A systematic review of literature. Iran J Nurs Midwifery Res 2019;24:417 27.

Escobar M, Nassar A, Theron G, Barnea E, Nicholson W, Ramasauskaite D, et al. FIGO recommendations on the management of postpartum hemorrhage 2022. Int J Gynecol Obstet 2022;157(Suppl 1):3 50.

Rahmanian SA, Aradmehr M, Irani M. The effect of medicinal plants on gynecological and obstetric hemorrhages: A systematic review of clinical trials. Iran J Obstet Gynecol Infertlity 2022;25:113 27.

Sohrabi Z, Ziagham S, Akbari M, Arasteh B. Effect of Oxygen inhalation on postpartum hemorrhage. Iran J Obstet Gynecol Infertil 2015;18:1 6.

Sekhavat L, Firuzabadi RD, Zarchi MK. Effect of postpartum oxygen inhalation on vaginal blood loss. J Matern Fetal Neonatal Med 2009;22:1072 5.

Kalaimathi S. Oxygen inhalation in the immediate postpartum period which reduces vaginal blood loss. J Nurs Trendz 2016;7:3 6.

Seidy J, Farhadifar F, Ghadami N, Zandvakili F, Roshani D, Taifoori L, et al. Effect of supplemental oxygen on the incidence and severity of nausea and vomiting in the patients after cesarean surgery under spinal anesthesia. Sci J Kurdistan Univ Med Sci 2010;15:26 35.

Güngördük K, Asicioğlu O, Yildirim G, Gungorduk OC, Besimoglu B, Ark C. Is post-partum oxygen inhalation useful for reducing vaginal blood loss during the third and fourth stages of labour? A randomised controlled study. Aust N Z J Obstet Gynaecol 2011;51:441 5.

Jørgensen L, Paludan Müller AS, Laursen DR, Savović J, Boutron I, Sterne JA, et al. Evaluation of the Cochrane tool for assessing risk of bias in randomized clinical trials: Overview of published comments and analysis of user practice in Cochrane and non Cochrane reviews. Syst Rev 2016;5:80.

Banupriya P. Effectiveness of oxygen inhalation on vaginal blood loss among mothers in the third and fourth stage of labour. Online J Gynecol Obstet Mat Care 2020;3:1 6.

Yatawatta AB, Ubhayawansa JK, Sugathadasa DP, Amarasinghe IW, Kumarasiri RP, Goonasekera CD. Oxygen inhalation in the immediate postpartum period reduces vaginal blood loss. J Obstet Gynecol India 2007;57:493 7.

Ostrowski R, Stępień K, Pucko E, Matyja E. The efficacy of hyperbaric oxygen in hemorrhagic stroke: Experimental and clinical implications. Arch Med Sci 2017;13:1217 23.

Wright JK, Ehler W, McGlasson DL, Thompson W. Facilitation of recovery from acute blood loss with hyperbaric oxygen. Arch Surg 2002;137:850 3.

Sun L, Zhou W, Mueller C, Sommer C, Heiland S, Bauer AT, et al. Oxygen therapy reduces secondary hemorrhage after thrombolysis in thromboembolic cerebral ischemia. J Cereb Blood Flow Metab 2010;30:1651 60.


Refbacks

  • There are currently no refbacks.