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2020 May 04

Int J Gynaecol Obstet

Correspondence: Adverse effect of delayed pushing on postpartum blood loss in nulliparous women with epidural analgesia.


We read with interest the paper by Fiedler et al.[1] which recommends against delayed active pushing in nulliparous women with epidural analgesia based on increased maternal blood loss. Although older literature did not show an increased risk of postpartum hemorrhage (PPH) with delayed pushing, more recent studies,[3-5] including this prospective cohort study,[1] have drawn contradictory conclusions.