Comparative study between active management and expectant management of third stage of labour

2021 ◽  
Vol 20 (3) ◽  
pp. 75-79
Author(s):  
Manjusha Kale ◽  
Keyword(s):  
Comparative Study ◽  
Expectant Management ◽  
Active Management ◽  
Third Stage

scholarly journals Third stage of labour: expectant versus active management-a comparative study in local low risk population

2019 ◽  
Vol 8 (2) ◽  
pp. 641
Author(s):  
Kavita A. Chandnani ◽  
Deepti D. Sharma
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Maternal Mortality ◽  
Post Partum ◽  
Expectant Management ◽  
Active Management ◽  
Research Centre ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. These deaths have a major impact on the lives and health of the families affected. Thus, anticipation as well as proper management of 3rd stage of labour is mandatory. The objective of this study was to compare expectant and active management of third stage of labour in preventing post-partum blood loss and having impact on prevention of maternal mortality in local population. Advantages and disadvantages of both techniques might be over estimated.Methods: Prospective comparative study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 200 laboring women admitted directly or from OPD to labour room for expected vaginal delivery. They were randomly allocated to group A (expectant management) and group B (active management). Labour progress was charted on partograph and interventions recorded. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for descriptive variables were calculated and appropriate statistical tests applied to determine significance.Results: Average PPBL (post-partum blood loss) was 360.5ml in group A as compared to 290.6ml in group B. 12 patients in group A had blood loss more than 500ml while none in group B. 66% cases in group B had duration of third stage of labour less than 5 min as compared to only 22% in group A. the mean duration of third stage was 13.46±8.3 in group A while 5.32±3.05 in group B. these differences were statistically significant.Conclusions: Active management of the third stage of labour is associated with less blood loss as well as a shorter duration of third stage compared with expectant management. It is reasonable to advocate this regime.

scholarly journals A Comparative Study of Oxytocin/Misoprostol/Methylergometrine for Active Management of the Third Stage of Labor

2014 ◽  
Vol 64 (3) ◽  
pp. 175-179 ◽  
Author(s):  
Megha Sharma ◽  
Parneet Kaur ◽  
Khushpreet Kaur ◽  
Arvinder Kaur ◽  
Preet Kanwal Kaur ◽  
...  
Keyword(s):  
Comparative Study ◽  
Active Management ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage

scholarly journals Retrospective cohort study comparing current third stage management to expedient squatting third stage management

2021 ◽  
Author(s):  
Judy Cohain ◽  
Rina E. Buxbaum
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Expectant Management ◽  
Positive Outcome ◽  
Low Risk ◽  
Active Management ◽  
Stage Management ◽  
The Third ◽  
Third Stage

Abstract Objective: To compare current the third stage management to expedient squatting at 3 minutes postpartum. Design, Setting, Sample and Methods: A retrospective cohort study of 1,098 planned, attended low risk vaginal births in Israel using Judy’s 3,4,5 minute third stage protocol compared to 2,691 attended low risk vaginal births in British Columbia using various forms of active or expectant management of the third stage of labor. Main Outcome measures: PPH>1000, PPH>500 and manual removal of placenta Results: Among similar groups of low risk births, active management, or expectant management resulted in 4.1% PPH over 1000 cc, whereas Judy’s 3,4,5 minute protocol resulted in 0% PPH over 500 cc. Conclusion: Evidence supports less postpartum bleeding and postpartum hemorrhage when women deliver the placenta in squatting 3 minutes after birth. The risks are minimal and the data suggests the likelihood of a very positive outcome, making it recommended for practitioners in all settings to try it.

scholarly journals Rectal Misoprostol versus Intramuscular Oxytocin for Prevention of Post Partum Hemorrhage

2012 ◽  
Vol 9 (1) ◽  
pp. 8-12 ◽  
Author(s):  
A Shrestha ◽  
A Dongol ◽  
C D Chawla ◽  
R Adhikari
Keyword(s):  
Side Effects ◽  
Outcome Measures ◽  
Postpartum Hemorrhage ◽  
Expectant Management ◽  
Active Management ◽  
Secondary Outcome ◽  
The Third ◽  
Third Stage Of Labor ◽  
Significant Difference ◽  
Third Stage

Background Postpartum hemorrhage (PPH) is an important cause of maternal morbidity and mortality especially in the developing countries. Compared to expectant management, active management decreases the incidence of PPH. Objective To compare the effectiveness of rectal misoprostol with intramuscular oxytocin in the prevention of postpartum hemorrhage. Methods This is a prospective, randomized and analytical study from 1stSeptember 2009 to 28th February 2010 at Department of Obstetrics and Gynecology, Dhulkhel Hospital - Kathmandu University Hospital, Dhulikhel, Nepal. A total of 200 women were included to receive either 1000 micrograms rectal misoprostol tablets or 10 units of oxytocin intramuscularly. Primary outcome measures were the incidence of postpartum hemorrhage or a change in hematocrit or hemoglobin from admission to day two post delivery. Secondary outcome measures including severe postpartum hemorrhage and the duration of the third stage of labor were noted. Also the side effects of both misoprostol and oxytocin were recorded. Results The frequency of postpartum hemorrhage was 4% in the misoprostol subjects and 6% in the control subjects (P=0.886) There were no significant difference among the groups in the drop of hematocrit (P>0.05). Secondary outcome measures including severe postpartum hemorrhage and the duration of the third stage of labor were similar in both groups. Similarly, the side effects between the misoprostol and oxytocin group within 6 hours was statistically significant (p=0.003) whereas the side effects within 24hours was statistically not significant (p=0.106). ConclusionRectal misoprostol is as effective as intravenous oxytocin in preventing postpartum hemorrhage with the similar incidence of side effects and is worthwhile to be used as a uterotonic agent for the routine management of third stage of labor.http://dx.doi.org/10.3126/kumj.v9i1.6254 Kathmandu Univ Med J 2011;9(1):8-12 

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