8.1 Normal third stage of labour
- 8.1.1 Description. This stage usually lasts 5 to 15 minutes. ...
- 8.1.2 Routine prevention of postpartum haemorrhage. Active management of third stage of labour consists in the administration of oxytocin before placental expulsion, followed by controlled cord traction then uterine massage ...
- 8.1.3 Monitoring. ...
- 8.1.4 Examination of the placenta. ...
What is active management of the third stage of Labour?
The original description of active management of the third stage of labour had three components—delivery of a prophylactic uterotonic drug, early cord clamping and cutting, and controlled cord traction.1 When randomised trials in the 1980s found that this package reduced the risk of severe postpartum haemorrhage by 70%,2 active management was ...
What happens to the placenta during the third stage of Labour?
This’ll make the placenta start to separate. You will have some bleeding during the third stage of labour as you pass the placenta (Begley et al, 2011). Generally, you have two options for how you do the third stage of labour: active management and physiological management.
Do You Bleed during the third stage of Labour?
You will have some bleeding during the third stage of labour as you pass the placenta (Begley et al, 2011). Generally, you have two options for how you do the third stage of labour: active management and physiological management.
What are the two approaches to managing the third stage?
There are two approaches to managing the third stage: active management. What is a natural third stage? A physiological or natural third stage means that you wait for the placenta to be delivered naturally. After your baby's birth, your midwife will delay clamping the umbilical cord to allow oxygenated blood to pulse from the placenta to your baby.
How do you manage the third stage of labor?
Active management of the third stage of labor involves prophylactic uterotonic treatment, early cord clamping and controlled cord traction to deliver the placenta. (2) Oxytocin is the first agent of choice for PPH prophylaxis because of its high efficacy and a low incidence of associated side effects.
Should active management of the third stage of labor be routine?
Based on the data from the reviewed studies, active management of the third stage of labor should be routine after uncomplicated vaginal deliveries in a hospital setting.
What is the first step of Amtsl active management of third stage of labor?
Therefore, AMTSL has to be applied routinely (to all delivering mothers). The sequential physiological changes in the third stage of labour are: separation of the placenta, descent of the placenta, expulsion of the placenta and control of bleeding.
What is passive management of 3rd stage of labour?
If the passive method has been used to manage the third stage of labour, a rapid intravenous infusion of 20 units oxytocin in 1000 ml Balsol or normal saline as a side infusion must be given. The placenta is delivered by controlled cord traction, i.e. the active method is used.
Which of the following nursing intervention would the nurse perform during the third stage of labor?
During the third stage of labor, which begins with the delivery of the newborn, the nurse would promote parent-newborn interaction by placing the newborn on the mother's abdomen and encouraging the parents to touch the newborn.
What are the benefits of active management of the third stage of labor?
Active management of the third stage of labor has been shown to reduce the incidence of PPH, the need for blood transfusion, and the use of therapeutic uterotonics during the third stage of labor and/or within the first 24 hours after birth.
Which activity occurs during the third stage of labor?
After the baby is delivered, the new mother enters the third and final stage of labor--delivery of the placenta (the organ that has nourished the baby inside of the uterus). This stage usually lasts just a few minutes and involves the passage of the placenta out of the uterus and through the vagina.
What drugs are used in the active management of the third stage?
Uterotonic agents Oxytocin: Oxytocin is the most commonly used agent and the primary drug of choice in the TSL. ... Ergometrine (methergine): Ergot alkaloids exert various effects throughout the body on at least three different types of receptor. ... Syntometrine: This contains 5 IU oxytocin and 0.5 mg ergometrine.More items...•
What are the complications of third stage of labour?
All women who deliver are at risk of complications in the third stage of labor. These complications include PPH, retained placenta, and uterine inversion. Others include conditions that commonly manifest for the first time during the third stage (eg, placenta accreta and its variants).
What is active management strategy?
An investment strategy that does not invest according to a market-value-weighted index. This strategy often requires regular buying and selling transactions. The objective of active management is to achieve an improved outperformance net of costs relative to the market.
What happens during the third stage of labor?
This process is always associated with a moderate blood loss – up to 500 millilitres. In this stage of labour, one of the potential problems is excessive bleeding (postpartum haemorrhage), which can result in anaemia and fatigue. This is why the third stage is carefully supervised.
What is the third stage of management?
There are two approaches to managing the third stage: natural (also known as physiological or expectant) management, or. active management.
What is the third stage of pregnancy?
A physiological or natural third stage means that you wait for the placenta to be delivered naturally. After your baby's birth, your midwife will delay clamping the umbilical cord to allow oxygenated blood to pulse from the placenta to your baby. Your uterus (womb) will contract, and the placenta will peel away from the wall of your uterus.
Why is it important to have an active third stage?
The advantage of an active third stage is the lower risk of very heavy bleeding immediately after the birth. Your midwife or doctor will recommend you have an active third stage if you had complications during pregnancy or labour, such as:
What is the third stage of labor?
The third stage of labour is the delivery of your Placenta (afterbirth) and the membranes that your baby has been protected by for the past nine months. Inside the uterus, the placenta plays the role of lungs, liver, and the kidneys for the babies. Blood flow to these organs is minimal until the baby takes a first breath, at which time big changes begin to the body of your baby. However, there are a lot of important things for you to know on what to expect during labour.
When is the third stage of a baby's birth?
The medical management of the third stage the cord is normally clamped immediately after the birth of the baby, usually within 30 seconds, and before it stops pulsating. The earlier the cord is clamped the less blood will pass from the placenta to the baby by placental transfusion.
What happens when the placenta goes down into the lower segment of the uterus?
The uterus becomes globular in shape and firmer – This occurs as the placenta goes down into the lower segment of the uterus and the body of the uterus continues to retract.
What is the third stage of labour?
Active management: Active management of the third stage of labour consists of interventions designed to facilitate the delivery of the placenta by increasing uterine contractions and to prevent primary postpartum haemorrhage (PPH) by averting uterine atony. The usual components include administration of uterotonic agents, controlled cord traction and uterine massage after birth of the placenta, as appropriate (ref ICM/FIGO joint statement).
How to stabilize uterus during CCT?
Place one hand above the level of the symphysis pubis, applying counter pressure in an upward direction, thus stabilising the uterus during CCT. This is sometimes referred to as ‘guarding the uterus’. Do not manipulate the uterus².
How long does it take for a placental expulsion to occur?
This precludes the administration of oxytocic drugs. This process may take from fifteen minutes to one hour.
What is the 3rd stage of labour?
The original description of active management of the third stage of labour had three components—delivery of a prophylactic uterotonic drug, early cord clamping and cutting, and controlled cord traction . 1 When randomised trials in the 1980s found that this package reduced the risk of severe postpartum haemorrhage by 70%, 2 active management was adopted widely. It was thought to be especially important in low resource settings, where more than 20 000 deaths occur each year as a result of haemorrhage. 3 In these settings, active management of the third stage has almost become a mantra for the safe motherhood movement.
Does oxytocin reduce the length of the third stage?
It also showed that in sites using oxytocin alone for prophylaxis, cord traction reduced the length of the third stage by six minutes but had no effect on manual removal rates. The same may not be true when the combined oxytocin-ergometrine preparation is used.
What is the third stage of labour?
This is called expectant management of third stage of labour. Active management of third stage involves three components: 1) giving a drug (a uterotonic) to help contract the uterus; 2) clamping the cord early (usually before, alongside, or immediately after giving the uterotonic); 3) traction is applied to the cord with counter-pressure on ...
Can women be given information on the benefits and harms of both methods to support informed choice?
Women could be given information on the benefits and harms of both methods to support informed choice. Given the concerns about early cord clamping and the potential adverse effects of some uterotonics, it is critical now to look at the individual components of third-stage management.
