الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
obstetrical emergency that can follow vaginal or cesarean delivery. It is a major cause of maternal morbidity and one of the top of three causes of maternal mortality in both high and low per capita income countries, although the absolute risk of death is much lower in high income countries (1 in 100,000 versus 1 in 1000 births in low income countries) (Mousa et al., 2003). Furthermore, (Allan, 2010) stated that hemorrhage is the leading cause of admission to the intensive care unit and the most preventable cause of maternal mortality. The present study was carried out with the aim of examining the effect of uterine massage to women during the third stage of labor on preventing postpartum hemorrhage. It was conducted at Obstetrics and Gynaecology department, Menoufia University Hospital. Research hypothesis was formulated and quasi-experimental design was used in carrying out the current study. Comparison of the study groups with each other regarding blood loss, time of placental delivery and use of uterotonics took place.The researcher used 400 patients as a sample size. The subjects of the study were randomly assigned to four equal groups as follows:Study group 1: women receiving Syntocinone and having uterine massage.Study group 2: women receiving Syntocinone and having no uterine massage.89 Study group 3: women who did not receive Syntocinone and have uterine massage Study group 4: women who did not receive Syntocinone and have no uterine massage The tool used in the data collection process was developed by the researcher then revised by qualified experts. It was a Structured Interview Questionnaire which included socio-demographic data, past medical history, family history, obstetric history, present history, data about present delivery and maternal outcomes during delivery.Human rights and ethical considerations were observed and considered in conducting the study. An oral consent to participate in the current study was taken after the purpose of the study was clearly explained to each subject. The researcher informed the subjects that participation in the study is voluntary. Confidentiality of obtained personal data as well as respect of participants’ privacy was totally ensured. The study had certain limitations, related to the subjects who included in the study. They were women who have single fetus, have given birth vaginally, who are free from any disease, without any complications during pregnancy and have only a tonic postpartum hemorrhage. The exclusion criteria included the women who have traumatic postpartum hemorrhage caused by lacerations of perineum, vagina or cervix, ruptured uterus, uterine inversion, episiotomy and use of 90 instrumentation or multiple pregnancies which may limit the generalizability of the findings regarding postpartum hemorrhage in general The main findings of the current study were as follows As regards to age, the age of patients ranged between 15 to 48 years with a mean of 25.58 and standard deviation of 4.99 Concerning the demographic characteristics of study candidates, the majority of cases were housewives (about 85%). Also the majority of cases were resident in rural area (about 73%). The current study found that about 10% had retained placenta, 34% recorded post partum hemorrhage and received additional uterotonics It revealed that there were significant differences between the studied groups and the amount of blood loss (P< 0.01) as the mean of blood loss was lower in the first and third groups than those of the second and fourth groups ; 103 and 133 ml versus 240 and 303mlduring the first hour respectively Regarding the blood loss on the first day postpartum, the study concluded that there were significant differences between the studied groups and the amount of blood loss (P< 0.01) as the mean of blood loss was lower in the first and third groups than those of the second and fourth group; 207 and 270 ml versus 432 and 587ml respectively The study finding revealed that there was a significant difference between the studied groups and the occurrence of postpartum hemorrhage; 69.1% of post partum cases received neither uterine massage nor Syntocinone but about 4 % of postpartum cases had both