An evaluation of the practice of active management of third stage of labour in a teaching hospital

Fathima, Naima; Rao, Mahil

doi:10.18203/2320-1770.ijrcog20161445

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…The WHO had integrated this intervention as active management of the third stage of labour (AMTSL) [1]. Later on, numerous researches had been done to evaluate the effectiveness of each component of AMTSL [2,3]. The administration of uterotonic drugs had been identified as the most important component of the intervention [4].…”

Section: Introductionmentioning

confidence: 99%

Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes

Elgzar¹,

Ibrahim²,

Elkhateeb³

2017

AJNR

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Background: Recent protocol proposed by the World Health Organization to manage the third stage of labour replaced the early cord clamping by deferred cord clamping to induce numerous neonatal benefits. But this practice is still resisted in most of the Arab countries. The aim of this study was to evaluate the effectiveness of deferred versus early umbilical cord clamping on maternal and neonatal outcomes. Methods: A quasi experimental research design was utilized. The study was conducted at labour unit in Damanhour National Medical Institute. Sample: A convenience sample of 150 parturient women undergoing normal vaginal delivery were randomly divided in two groups; deferred cord clamping (n= 75) and early cord clamping (n= 75). Tools: Three tools were used for data collection; 1) Structured interview schedule to collect data about the women' demographic characteristics and reproductive history. 2) Maternal outcomes assessment sheet. 3) Neonatal outcomes assessment sheet to assess the immediate and late neonatal outcomes. Results: There were no statistically significant differences (P > 0.05) between deferred and early cord clamping groups in relation to the maternal risk for post-partum hemorrhage, duration of third stage of labour and the need for manual removal of the placenta. Furthermore, a highly statistically significant differences (p < 0.001) were observed regarding neonatal hemoglobin, hematocrit, and red blood cells between the two groups. The mean total bilirubin level was significantly higher (P < 0.05) in the deferred cord clamping group than early cord clamping group. Conclusion: The study concluded that deferred umbilical cord clamping did not increase the risk of maternal post-partum hemorrhage, duration of third stage of labour or the need for manual removal of the placenta. Also, deferred cord clamping significantly increased neonatal hemoglobin, hematocrit, and red blood cells level without serious elevation in the total bilirubin level as it was still in the low intermediate risk or below 75 th percentile. Recommendation: Institutionalization of deferred cord clamping in all governmental hospitals and medical educational settings through providing policies, procedures and guidelines regarding this practice. This could significantly improve the intra-natal care for the neonate without harmful consequences for the mother.

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Section: Introductionmentioning

confidence: 99%

Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes

Elgzar¹,

Ibrahim²,

Elkhateeb³

2017

AJNR

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“…9 When contrasted with expectant management of the third stage of labour (which involves no use of oxytocic), AMTSL reduced PPH by 60%–70%, maternal postpartum anaemia by 50%, blood transfusion by 65% and use of therapeutic uterotonics by 81%. 10 – 12 The benefits of AMTSL in preventing and reducing primary PPH following vaginal delivery for women without significant risk of PPH have been reported in a meta-analysis. 13 …”

Section: Introductionmentioning

confidence: 99%

Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial

Okaforcha,

Eleje,

Ikechebelu

et al. 2024

SAGE Open Medicine

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Objectives: To compare the efficacy and safety of intravenous and intramuscular oxytocin in preventing atonic primary postpartum haemorrhage in the third stage of labour. Methods: A double-blind randomised clinical study on consenting women without risk factors for primary postpartum haemorrhage in labour at term. Two hundred and thirty-two women were randomly allotted into intravenous ( n = 115) and intramuscular ( n = 117) oxytocin groups in the active management of the third stage of labour. All participants received 10 IU of oxytocin, either IV or IM, and 1 ml of water for injection as a placebo via a route alternate to that of administration of oxytocin within 1 min of the baby’s delivery. The primary outcome measures were mean postpartum blood loss and haematocrit change. Trial Registration No.: PACTR201902721929705. Results: The baseline socio-demographic and clinical characteristics were similar between the two groups ( p > 0.05). There was no statistically significant difference between the two groups with regards to the mean postpartum blood loss (254.17 ± 34.85 ml versus 249.4 ± 39.88 ml; p = 0.210), haematocrit change (2.4 (0.8%) versus 2.1 (0.6%); p = 0.412) or adverse effects ( p > 0.05). However, the use of additional uterotonics was significantly higher in the intravenous group (25 (21.73%) versus 17 (14.53%); p = 0.032). Conclusion: Although oxytocin in both study groups showed similar efficacy in terms of preventing atonic primary postpartum haemorrhage, participants who received intravenous oxytocin were more likely to require additional uterotonics to reduce their likelihood of having an atonic primary postpartum haemorrhage. However, both routes have similar side effect profiles.

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An evaluation of the practice of active management of third stage of labour in a teaching hospital

Cited by 2 publications

References 9 publications

Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes

Effects of Deferred Versus Early Umbilical Cord Clamping on Maternal and Neonatal Outcomes

Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial

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