No. 235-Active Management of the Third Stage of Labour: Prevention and Treatment of Postpartum Hemorrhage

Active management of third stage of labour is an effective method of preventing postpartum hemorrhage. It includes administration of uterotonic immediately after delivery of the baby, delaying cord clamping for at least 1-3 minutes to reduce rates of infant anaemia, performing controlled cord traction for removing the placenta and postpartum vigilance, ie, assess the uterine tone to ensure a contracted uterus; and continue to check every 15 minutes for 2 hours. If there is uterine atony, fundal massage should be performed and patient should be monitored more frequently. Though oxytocin is the best drug for routine prophylaxis, misoprostol is a relatively newer drug which is now included in the various guidelines for prevention and treatment of postpartum hemorrhage. It can be used as an effective and safe drug in areas with poor access to skilled healthcare providers and facilities.

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P256 Controlled cord traction in active management of the third stage (AMTSL) for the prevention of postpartum hemorrhage: FIGO saving mothers and newborns project activities in Ukraine

International Journal of Gynecology & Obstetrics ◽

10.1016/s0020-7292(09)61746-x ◽

2009 ◽

Vol 107 ◽

pp. S485-S486

Author(s):

I. Mogilevkina ◽

V. Chaika ◽

N. Morozova ◽

A. Shipunova ◽

Y. Khaletskiy ◽

...

Keyword(s):

Postpartum Hemorrhage ◽

Active Management ◽

The Third ◽

Third Stage ◽

Controlled Cord Traction

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Assessment of Midwife Knowledge, Practice, and Associated Factors towards Active Management of the Third Stage of Labor at Governmental Health Institutions in Tigray Region, Northern Ethiopia, 2018

BioMed Research International ◽

10.1155/2020/8547040 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Getu Engida Wake ◽

Girma Wogie

Keyword(s):

Postpartum Hemorrhage ◽

Active Management ◽

Knowledge Level ◽

Practice Level ◽

Tigray Region ◽

The Third ◽

Third Stage Of Labor ◽

Third Stage ◽

Knowledge Practice ◽

Health Institutions

Introduction. Globally, postpartum hemorrhage is the most common cause of maternal mortality and morbidity, and it accounts for more than 25% of all maternal deaths. The majority of death due to postpartum hemorrhage is caused by uterine atony. Routine and correct usage of active management of the third stage of labor decreases the occurrence of postpartum hemorrhage by 60% when compared to expectant management of the third stage of labor. The purpose of this study was to assess midwife knowledge, practice, and associated factors towards active management of the third stage of labor at governmental health institutions in the Tigray region, 2018. Results. These study results showed that from the total study participants ( N = 278 ), 170 (61.2%) were good in knowledge and 121 (43.5%) were good in practice towards active management of the third stage of labor. Training related to active management of the third stage of labor ( AOR = 2.119 , 95 % CI = 1.141 , 3.3937) and practice level of midwives ( AOR = 8.089 , 95 % CI = 4.103 , 15.950) became significantly associated with the knowledge level. The educational level of midwives ( AOR = 3.811 , 95 % CI = 2.015 , 7.210), training related to active management of the third stage of labor ( AOR = 2.591 , 95 % CI = 1.424 , 4.714), and knowledge level of midwives towards active management of the third stage of labor ( AOR = 7.324 , 95 % CI = 3.739 , 14.393) were significantly associated with the practice level. This study showed that training related to active management of the third stage of labor was significantly associated with the knowledge and practice level of midwives. The educational level and knowledge level of midwives were significantly associated with the practice level of midwives towards active management of the third stage of labor. Therefore, midwives should update their academic level and knowledge. Health institutions in collaboration with the Tigray Regional Health Bureau should arrange training for all midwives to bring change.

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