The document discusses active management of the third stage of labor. The third stage of labor occurs from childbirth until delivery of the placenta, which typically takes 5-15 minutes but is considered prolonged after 30 minutes. Most cases of postpartum hemorrhage (PPH) occur during the third stage. Active management consists of interventions like uterotonic drugs, controlled cord traction, and uterine massage to speed placental delivery and prevent PPH by ensuring uterine contraction. It has advantages of shorter third stage and lower PPH risk but requires oxytocics, injection skills, and trained birth attendants.

1. BeMonc tr
@ 2016

2. ACTIVE MANAGEMENT OF
THIRD STAGE OF LABOUR

3. Introduction
• The third stage of labor is the period of time from
the birth of the child until the placenta is delivered.
• During this time, the muscles of the uterus contract
and the placenta begins to separate from the uterine
wall.
• The amount of blood lost depends on how quickly
this occurs.

4. Third stage of labour -1
• The third stage typically lasts between 5 and 15
minutes.
• After 30 minutes, the third stage of labour is
considered prolonged, indicating a potential
problem.

5. Third stage of labour -2
• Most cases of PPH occur during the third stage of
labour
• Active management consists of interventions
designed to speed the delivery of the placenta by
increasing uterine contractions thus preventing PPH
by averting uterine atony.

6. Components of AMTSL
• Administering a uterotonic drug within one minute
of birth of the newborn.
• Applying controlled cord traction to the umbilical
cord while applying simultaneous counter-pressure to
the uterus through the abdomen; and
• Immediately massaging the funds of the uterus
through the woman’s abdomen until the uterus is
contracted.

7. 7
Active Management: Advantages and
Disadvantages
• Advantages
– Decreases length of third stage
– Decreases risk of PPH
• Disadvantages
– Requires oxytocics and items needed for injection
– Requires a birth attendant with skills in:
• Observation
• Giving an injection
• CCT