The Effectiveness of Placental Drainage in the Active Management of the Third Stage against the Duration of Three Childbirths in the Independent Practice of Midwives in Banda Aceh City

BACKGROUND: The third stage of active management has become a standard practice in delivery management. Implementation of childbirth care requires accelerated release of the placenta to avoid bleeding. Placental drainage can shorten the duration of the three stages and reduce blood loss during labor. AIM: The aim of the study is to analyzing the effectiveness of placental drainage in the third stage active management of the third stage of delivery at the midwife’s independent practice (PMB) in the city of Banda Aceh. METHODS: This study used a Quasi Experiment design with a post-test control design. This research was carried out for 12 weeks at the PMB in Banda Aceh City, namely mothers who gave birth at the Erni Munir PMB and the Independent Practice Midwife Mutia Yacob. The sampling technique was purposive sampling. The sample in this study amounted to thirty mothers giving birth, divided into two groups, namely, the treatment group with placental drainage as many as 15 mothers and respondents with cord clamping as many as 15 mothers. With the inclusion criteria, the mother is willing to be a respondent, the vital signs of normal mothers, single and live fetuses, term pregnancy, and an interpretation of average fetal weight ≥ 2500 g. Data analysis used the MannWhitney test, with a confidence level of 95%. RESULTS: The results showed a difference in effectiveness between the placental drainage group and the umbilical cord clamping group, as evidenced by a statistical test with p = 0.001. The length of three stages required by mothers to give birth with placental drainage has a mean value of 4.47 min with a standard deviation of 0.516. The average length of time required by the mother to give birth with umbilical cord clamping is 5.40 min with a standard deviation value of 0.828. CONCLUSION: Placental drainage was more effective than umbilical cord clamping to shorten the third stage length in the Independent Practice of Midwives in Banda Aceh City.

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Delayed Cord Clamping in Term Neonates: Attitudes and Practices of Midwives in Irish Hospitals

International Journal of Childbirth ◽

10.1891/2156-5287.8.1.4 ◽

2018 ◽

Vol 8 (1) ◽

pp. 4-17 ◽

Cited By ~ 3

Author(s):

Joan Devin ◽

Patricia Larkin

Keyword(s):

Umbilical Cord ◽

Active Management ◽

Delayed Cord Clamping ◽

Term Neonates ◽

The Third ◽

Cord Clamping ◽

Third Stage Of Labor ◽

Maternity Hospitals ◽

Third Stage ◽

Early Cord Clamping

Background:At the time of birth, the baby is attached to its mother’s placenta via the umbilical cord. A delay in cord clamping is physiologically beneficial to the neonate as they receive an increase in blood volume (30%–40%), increased iron stores (20–30mg/kg), and an easier transition to extrauterine life. Active management of the third stage of labor, in order to prevent maternal postpartum hemorrhage, may contribute to early cord clamping practices in Ireland. Objective:To describe the current practices and attitudes of midwives in Irish hospitals toward delayed cord clamping in term neonates. Methods:A cross-sectional descriptive survey was distributed to three maternity hospitals and two Irish online midwifery groups. Results:One hundred and fifty-three valid responses were received. One hundred and eleven midwives (72.4%) defined delayed cord clamping as “clamping after the cord ceases to pulsate.” One hundred and forty (91.5%) respondents practiced delayed cord clamping. Moreover, 62.7 % (98/153) of participants routinely clamp the umbilical cord >1 minute when practicing active management of the third stage, with 49.1% (48/98) of those waiting until cord pulsations have ceased. Awareness of research, practice guidelines advising delayed cord clamping, and experience of practicing physiological third stage are associated with increased delayed cord clamping practices. Early cord clamping is influenced by a deteriorating neonatal or maternal condition and the cultural context within clinical sites. Delayed cord clamping times during active management of the third stage differ significantly between clinical sites and maternity care pathways.Conclusion:A variety of midwifery practices were identified with differing attitudes toward cord clamping practices. Diverse influences included the practice environment, awareness of research, and availability of adjunct resuscitation supports. Recommendations for future practice include a synchronized approach to delayed cord clamping in the third stage of labor, including the provision of a national guideline.

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PRIMERJAVA PREDNOSTI IN SLABOSTI TAKOJŠNJE TER ODLOŽENE PREKINITVE POPKOVNICE PRI NOVOROJENČKU

Slovenian Medical Journal ◽

10.6016/zdravvestn.1223 ◽

2015 ◽

Vol 84 (7-8) ◽

Author(s):

Tamara Serdinšek ◽

Andraž Dovnik ◽

Iztok Takač

Keyword(s):

Respiratory Distress ◽

Active Management ◽

Preterm Neonates ◽

Delayed Cord Clamping ◽

Birth Canal ◽

The Third ◽

Cord Clamping ◽

Third Stage ◽

Umbilical Cord Clamping ◽

The Usa

Background: Umbilical cord clamping in the third stage of labour is still controversial. Early cord clamping is defined as clamping at 10, 15, 30 or 60 seconds after delivery and delayed as clamping after 60 seconds or at 2-5 minutes after delivery, when the cord stops pulsating or when the placenta is visible within the birth canal. Early clamping is one of the three components of active management of the third stage of labour, which has been used widely in modern obstetrics during the last century. However, in some northern European countries, various parts of the USA and Canada and in developing countries physiological management is preferred.Conclusions: After publication of several trials describing advantages of delayed clamping, this has recently been progressively replacing early clamping. The most important advantages of delayed cord clamping are higher haemoglobin and ferritin levels, higher iron stores, lower incidence of iron deficiency anaemia, better cardiopulmonary adaptation, lower rate of respiratory distress syndrome, and longer duration of early breastfeeding in term neonates, while there is no increase in the incidence of postpartum haemorrhage. Delayed clamping seems to bring some advantages for preterm neonates as well. However, caution is still advised because of the potential adverse effects, especially polycythaemia with hyperviscosity, hyperbilirubinaemia and respiratory distress.

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DRAMATURGI KESENIAN TRADISIONAL DALUPA PRODUKSI SANGGAR SENI DATOK RIMBA DI WOYLA ACEH BARAT

Gorga Jurnal Seni Rupa ◽

10.24114/gr.v10i1.22730 ◽

2021 ◽

Vol 10 (1) ◽

pp. 15

Author(s):

Susandro Susandro ◽

Rika Wirandi ◽

Hatmi Negria Taruan

Keyword(s):

New York ◽

Creative Process ◽

Creation Process ◽

Folk Tale ◽

The Third ◽

The People ◽

Third Stage ◽

Three Stages ◽

Banda Aceh

Dalupa art emerged from the creative process of the people of West Aceh which can be stretched into three stages. First, Dalupa was originally a folk tale or folklore that was narrated from generation to generation. Second, the Dalupa then manifests (a person wearing the costume of a Dalupa character) so that it can be witnessed in person. At this stage, the Dalupa character does not manifest itself in the form of theater or dance. Its presence is only intended to entertain or enliven an event, such as weddings, processions, campaigns and so on. Third, the Dalupa character is presented by considering the dramatic element; arrangement of a series of events that tell the beginning of the appearance to the end of the Dalupa story. This study aims to record and describe how the process of creating the Dalupa art, as mentioned in the third stage. The method used is qualitative with the dramaturgy approach. This study shows the results that the art of Dalupa presents a story about the origin of the appearance of Dalupa with the manifestation of organized events. On this basis, it can be concluded that Dalupa art can be categorized as dramatic or theater art.Keywords: dalupa, creation process, dramatic, dramaturgy.AbstrakKesenian Dalupa muncul dari proses kreatif masyarakat Aceh Barat yang dapat direntangkan menjadi tiga tahap. Pertama, Dalupa mulanya merupakan cerita rakyat atau folklor yang dinarasikan secara turun-temurun. Kedua, Dalupa kemudian mewujud (seseorang yang mengenakan kostum tokoh Dalupa) sehingga dapat disaksikan secara langsung. Pada tahap ini, tokoh Dalupa mewujud tidaklah dalam bentuk kesenian teater atau tari. Kehadirannya hanya bertujuan untuk menghibur atau meramaikan suatu acara, seperti pernikahan, arak-arakan, kampanye dan sebagainya. Ketiga, tokoh Dalupa dihadirkan dengan mempertimbangkan unsur dramatika; penataan rangkaian peristiwa yang menceritakan awal kemunculan hingga akhir kisah Dalupa. Penelitian ini bertujuan mencatat serta memaparkan bagaimana proses penciptaan kesenian Dalupa, sebagaimana disebut pada tahap ketiga. Metode yang dilaksanakan yaitu kualitatif dengan pendekatan dramaturgi. Penelitian ini menunjukkan hasil bahwa kesenian Dalupa menyajikan cerita tentang asal mula kemunculan Dalupa dengan perwujudan peristiwa-peristiwa yang tertata. Atas dasar tersebut, dapat dismpulkan bahwa kesenian Dalupa dapat dikategorikan sebagai seni dramatik atau teater. Kata Kunci: dalupa, proses penciptaan, dramatika, dramaturgi. Authors: Susandro : Institut Seni Budaya Indonesia Aceh Rika Wirandi : Institut Seni Budaya Indonesia Aceh Hatmi Negria Taruan : Institut Seni Budaya Indonesia Aceh References:Barba, Eugenio. (2010). On Directing and Dramaturgy: Burning the House. New York: Routledge.Harymawan. (1993). Dramaturgi. Bandung: Rosdakarya.Herman, RN. (2016). Dalupa: Teater Tradisional Pantai Barat. Buletin Tuhoe edisi XVII. Banda Aceh: JKMA Aceh.Koster, G.L. (1998). Kacamata Hitam Pak Mahmud Wahid Atau Bagaimanakah Meneliti Puitika Sebuah Sastra Lisan?, dalam Pudentia MPSS (Ed.), Metodologi Kajian Tradisi Lisan. Jakarta: Yayasan Obor Indonesia dan Yayasan Asosiasi Tradisi Lisan.Moleong, Lexy J. (2005). Metodologi Penelitian Kualitatif, Ed. Revisi cetakan keduapuluhsatu. Bandung: Rosdakarya.Pramayoza, Dede. (2013). Dramaturgi Sandiwara: Potret Teater Populer Dalam Masyarakat Poskolonial. Yogyakarta: Penerbit Ombak.Soedarsono, R.M. (2001). Metodologi Penelitian Seni Pertunjukan dan Seni Rupa. Bandung: MSPI (Masyarakat Seni Pertunjukan Indonesia).SSDR. (2019). “Dramaturgi Kesenian Tradisional Dalupa”. Hasil Dokumentasi Pribadi: _________ 2020, Aceh Barat.Stokes, Jane. (2007). How to do Media and Kultural Studies: Panduan Untuk Melaksanakan Penelitian dalam Kajian Media dan Budaya. Terj. Santi Indra Astuti. Yogyakarta: Bentang.Taruan, H.N. (2020). “Dramaturgi Kesenian Tradisional Dalupa”. Hasil Dokumentasi Pribadi: _________ 2020, Aceh Barat. Wirandi, R. (2020). “Dramaturgi Kesenian Tradisional Dalupa”. Hasil Dokumentasi Pribadi: _________ 2020, Aceh Barat.

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Active management of third stage of labour by oxytocin: Umbilical vein versus intramuscular use

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v2i1.1469 ◽

1970 ◽

Vol 2 (1) ◽

pp. 13-16 ◽

Cited By ~ 1

Author(s):

Neebha Ojha ◽

Dibya S Malla

Keyword(s):

Blood Loss ◽

Umbilical Vein ◽

Maternity Hospital ◽

Active Management ◽

Cord Clamping ◽

Group I ◽

Third Stage ◽

Umbilical Cord Clamping ◽

Prospective Comparative Study ◽

Added Benefit

Aim: To compare oxytocin used via intraumbilical or intramuscular route in the active management of third stage of labour with respect to duration and amount of bleeding. Methods: Prospective comparative study conducted in Maternity Hospital, Thapathali, Kathmandu for three months 29th April - July 28th 2004 (061/1/16 to 061/4/12 BS ). After immediate umbilical cord clamping following vaginal delivery, 120 women were divided into 2 groups administering 10 units of oxytocin; in Group I: which was diluted mixing with 10 ml of normal saline before it was infused intraumbilical and Group II: injected intramuscularly. Results: There was no difference in the duration of third stage of labour (3.6 vs. 3.7min) between the two groups. There was significant blood loss in the intraumblical group as compared to intramuscular group (242ml vs.168ml, p. 0.004). The need for additional oxytocic to control the uterine bleeding was more in intraumbilical group as compared to intramuscular group (28.3% vs 6.7%, p 0.005). There was more postpartum haemorrhage (PPH) in intraumbilical group (8.3% vs 3.3%, p 0.439). The injection delivery interval was significantly longer in the intraumbilical group as compared to intramuscular group (46.9 vs. 30.7 sec). Conclusion: Intraumbilical oxytocin is technically more difficult to administer without having any added benefit either in decreasing the duration of third stage of labour or reducing the blood loss. Key words: Intraumbilical oxytocin, intramuscular oxytocin, third stage of labour. doi:10.3126/njog.v2i1.1469 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 13 - 16 May -June 2007

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Natural and Synthetic Oxytocin—Structurally Same but Differ in Effects—A Pilot Study

10.21203/rs.3.rs-345886/v1 ◽

2021 ◽

Author(s):

Katarzyna Wszołek ◽

Karolina Chmaj-Wierzchowska ◽

Małgorzata Pięt ◽

Agata Tarka ◽

Maciej Wilczak

Keyword(s):

Umbilical Cord ◽

Labor Induction ◽

Active Management ◽

Second Stage Of Labor ◽

Second Stage ◽

The Third ◽

Third Stage Of Labor ◽

Third Stage ◽

Synthetic Oxytocin ◽

Umbilical Cord Vein

Abstract Purpose: synthetic oxytocin is currently used to induce labor and strengthen the contractile function in the first or second stage of labor. It is also used therapeutically and prophylactically in the third stage of labor. We aimed to correlate the dose and duration of synthetic oxytocin infusions used during induction of labor, augmentation of labor in the first and second stage of labor, and during active management of labor in the third stage of labor to the level of prolactin and cortisol in the serum of the parturient blood and from the umbilical cord vein.Methods: The mother’s blood was collected from a venous vessel and foetal from the umbilical cord vein just cutting was performed and the levels of cortisol and prolactin was evaluated by electrochemiluminescence (ECLIA). The blood sample from the umbilical cord vein and artery were collected to separate heparinized capillaries and the pH, base deficit (BD), pO2, and CO2 concentration were assessed.Results: We observed decreased level of prolactin immediately after the labor depending on the total dose of synthetic oxytocin used. We did not observe any relationship between the level of prolactin on postpartum day 2 on the dose of administered hormone or the fact of the labor induction. We observed significant correlations with regard to hormone levels without the synthetic oxytocin total dosage correlation. Conclusion: We strongly believe that the definition of uniform norms and principles with regard to the dosage of synthetic oxytocin for labor induction should be determined.

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Management of the Third Stage of Labor: How Delayed Umbilical Cord Clamping Can Affect Neonatal Outcome

American Journal of Perinatology ◽

10.1055/s-0037-1603733 ◽

2017 ◽

Vol 34 (14) ◽

pp. 1375-1381 ◽

Cited By ~ 7

Author(s):

Mitchell Kresch

Keyword(s):

Umbilical Cord ◽

Neonatal Resuscitation ◽

Delayed Cord Clamping ◽

Ample Evidence ◽

Cord Clamping ◽

Third Stage Of Labor ◽

Third Stage ◽

Umbilical Cord Clamping ◽

Short And Long Term

AbstractThis review presents the effects of delayed umbilical cord clamping on neonatal transitional physiology. The effects of delayed cord clamping on short- and long-term neonatal outcomes are then discussed. There is ample evidence over the last 50 years that delayed cord clamping in preterm infants is beneficial for both short-term and long-term outcomes. Providing ventilation in the initial steps of neonatal resuscitation prior to clamping of the umbilical cord has a physiologic basis and results in better outcomes for newborns. The challenge now is to design equipment and strategies that can allow initial resuscitation very close to the mother while the umbilical cord is still attached to the placenta.

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Comparison of Oral Misoprostol with Intravenous Oxtocin in the In the Management of the Third Stage of Labour: A Randomized Controlled Trial

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v8i09.015 ◽

2021 ◽

Vol 8 (09) ◽

Author(s):

Ifeanyi Onyekpa ◽

Odugu BU ◽

Onah LN ◽

Okafor II

Keyword(s):

Developing Countries ◽

Statistical Analysis ◽

Postpartum Haemorrhage ◽

Active Management ◽

The Third ◽

Cord Clamping ◽

Oral Misoprostol ◽

Significant Difference ◽

Third Stage ◽

Labour Ward

Background: Postpartum haemorrhage (PPH) is defined as the loss of 500ml of blood or more from the vagina following vaginal birth or 1000ml following caesarean delivery. The third stage of labour is the period between the delivery of the baby and the delivery of the placenta and membranes and its management is central to the prevention of postpartum haemorrhage (PPH). There are basically two methods of managing the third stage of labour namely active and physiological/expectant. The active management includes the use of uterotonic drugs immediately following delivery of the fetus, early cord clamping and cutting, and controlled umbilical cord traction. The active management of the third stage of labour with oxytocin has been found to reduce the risk of primary PPH significantly; however, the problem of inadequate supply of electricity, high cost and paucity of skilled manpower to administer it has negatively affected its use in developing countries and has made the search for a more suitable alternative expedient. Misoprostol on the other hand has been found to have good uterotonic activities, affordable and stable at room temperature; making its use in the resource-poor countries a veritable alternative. Aims: To determine if there is any difference in the efficacy of intravenous oxytocin over oral misoprostol in the management of the third stage of labour Study Design: This was a prospective, double-blinded, randomized trial of uncomplicated pregnant women who had vaginal delivery in the labour ward of the ESUT Teaching Hospital, Enugu. Sample Size: Two hundred (200) pregnant women who satisfied the inclusion criteria were recruited into the study with each arm accommodating 100 participants. Methodology: The eligible women were recruited on presentation to the labour ward after giving their consent. They were randomly allocated into 2 groups: A and B. Group A received 2 tablets (400µg) of oral misoprostol and 1mililtre(ml) of sterile water intravenously while group B received 2 tablets of white vitamin c and 1ml (10iu) of intravenous oxytocin immediately after cord clamping and cutting following the delivery of the baby. The patient was observed for significant clinical vaginal bleeding or PPH. For the purposes of this study, any bleeding/PPH accompanied with a greater than 30% rise in baseline pulse rate qualified for transfusion. A proforma was used to record the necessary data Statistical Analysis: Data collected from the study was analyzed with the Statistical Package for Social Sciences (SPSS) computer software version 20.0 for Windows. Statistical analysis was both descriptive and inferential at 95% confidence level. The socio-demographic variables were used to categorize the data and this was subjected to comparative statistical evaluation to yield frequencies, means, and percentages. Test of significance between class differences was by Pearson’s Chi-square test for categorical variables and student’s t-test for continuous variables. All P<0.05 at one degree of freedom (df=1) was considered statistically significant. Results and Conclusion: There was no significant difference in the number of women that received blood transfusion, the amount of blood transfused and the need for additional oxytocics on both arms of the study. However, there was a significant difference in the occurrence of side-effects with shivering and vomiting being prominent in the misoprostol and oxytocin arms respectively. Conclusion: There was no difference in the efficacy of oxytocin over misoprostol in the management of the 3rd stage of labour. We therefore, recommend that misoprostol can be adopted as an alternative/substitute to oxytocin in the management of the third stage of labour especially in developing countries.

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Immediate effects of clamping of the umbilical cord on the newborns

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192022 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1251

Author(s):

Muhammad Hassan ◽

Adarsh E. ◽

Sahana Manjunath ◽

Shivtej N. ◽

Archana D. V. ◽

...

Keyword(s):

Umbilical Cord ◽

World Health ◽

Optimal Time ◽

Optimal Timing ◽

Delayed Cord Clamping ◽

Medical College ◽

Cord Clamping ◽

Third Stage ◽

Umbilical Cord Clamping ◽

Health Organization

Background: The optimal timing of cord clamping has been a controversial issue for decades. Most practitioners in developing countries clamp and cut the cord immediately after birth and this takes place during the third stage of labour. World Health Organization advises late cord clamping, however there is a debate on the optimal time for cord clamping. Delayed umbilical cord clamping appears to be beneficial for term and preterm infants.Methods: This observational study was undertaken at Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India from June 2018 to January 2019.Results: Total 100 neonates were studied of which 48 were females (48%) and 52 were males (52%). 76 babies (76%) were 3 day old in this study and 24 babies were (24%) 4 day old during the study period. 92 babies (92%) didn’t receive phototherapy in this study and 8 babies (8%) required phototherapy during the study period. No babies were polycythemic during this study period. Mean TB was 11.832 whereas mean DB was 0.5. Mean HCT was 56.332 and mean HB was 18.3002.Conclusions: Present study concluded that there are various advantages if authors practiced delayed cord clamping including higher levels of haemoglobin and haematocrit levels.

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