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Throughout the history, the neonate was dependent on maternal touch and care for survival. In modern obstetrics, with hospital care the neonates are seldom separated from their mothers after delivery. Early skin to skin (ESTS) contact after delivery was found to increase milk production, lactation and improve maternal and neonatal outcome.
Oxytocin is the primary hormone responsible for uterine contraction and prevention of postpartum hemorrhage (PPH). ESTS contact increases oxytocin secretion.
The rate of cesarean deliveries (CDs) increased dramatically over the past decades. CD was found to decrease postpartum milk production, postpones early lactation and decreases exclusive breastfeeding.
During the typical CD, the neonate is usually presented for a short while to the mother and breastfeeding is usually delayed at least a number of hours until after the surgery and the recovery period.
Natural CD, enable ESTS contact during the surgery and give the mother the opportunity to start breastfeeding immediately after delivery of the neonate in the surgery suit. Oxytocin secretion increases with ESTS and during breastfeeding.
The aim of this study is to examine blood loss that occurs after Natural CD compared to standard CD without an ESTS contact.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Natural cesarean delivery | Experimental | Placing the neonate on maternal chest immediately after the extraction from the uterus, and permitting breastfeeding during surgery. |
|
| Standard cesarean delivery | Active Comparator | Presentation of the neonate to the mother during the operation. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Natural cesarean delivery | Other | Natural cesarean delivery |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Hemoglobin level after delivery | Difference between pre- and post-surgical hemoglobin levels. | 4 days |
| Measure | Description | Time Frame |
|---|---|---|
| Blood product transfusion | Number of Packed red blood cells and plasma products | 4 days |
| Pain score during the operation | 1 hour | |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Raed Salim, MD | Emek Medical Center, Afula, Israel | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Ob/Gyn, Ha'Emek Medical Center | Afula | Israel |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35398585 | Derived | Zafran N, Garmi G, Abdelgani S, Inbar S, Romano S, Salim R. Impact of "natural" cesarean delivery on peripartum blood loss: a randomized controlled trial. Am J Obstet Gynecol MFM. 2022 Jul;4(4):100642. doi: 10.1016/j.ajogmf.2022.100642. Epub 2022 Apr 8. |
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| ID | Term |
|---|---|
| D006473 | Postpartum Hemorrhage |
| ID | Term |
|---|---|
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
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| Standard cesarean delivery |
| Other |
Standard cesarean delivery |
|
| Pain score during the first day after cesarean delivery |
Use of analgesic drugs |
| 24 hours |
| Analgesia use during the operation | Use of analgesic drugs | 1 hour |
| Analgesia use during the first day after cesarean delivery | 24 hours |
| Rate of breastfeeding at maternal hospital discharge | 4 days |
| Rate of breastfeeding 6 months after delivery | 6 months |
| Maternal satisfaction of the delivery | Satisfaction scale | 4 days |
| Breast engorgement | Diagnosed by physical examination | 4 days |
| Neonatal temperature after delivery | Temperature | 1 hour |
| D011644 | Puerperal Disorders |
| D014592 | Uterine Hemorrhage |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |