QUESTIONS AND ANSWERS
Active management of the third stage of labour - ANS consists of interventions designed to
facilitate the delivery of the placenta by increasing uterine contractions and to prevent PPH by
averting uterine atony.
Within one minute of the delivery of the baby, - ANS palpate the abdomen to rule out the
presence of an additional baby or babies and give oxytocin 10 units intramuscularly (IM).
The usual components of Active management of the third stage of labor include: - ANS •
administration of uterotonic agents
• controlled cord traction
• uterine massage after delivery of the placenta, as appropriate
Oxytocin is preferred over other uterotonic drugs because - ANS • it is effective 2 to 3
minutes after injection
• has minimal side effects
• can be used in all women.
3rd stage of labor is definition - ANS the period following the birth of the newborn through
the expulsion of the placenta.
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, maximum safe Lidocaine dosages - ANS • 4.5 mg/kg, up to 300 mg Lidocaine w/o
epinephrine
• 7 mg/kg, up to 500 mg Lidocaine w/ epinephrine
the signs of placental separation. - ANS • A small gush of blood
• Lengthening of the umbilical cord
• Rise of the uterus into the abdomen
• The uterus becomes firm and rounded
Three Components of AMTSL according to the ICM/FIGO Joint Statement (2003) are: - ANS •
Administration of a uterotonic medication within one minute of the birth of the baby, after
ruling out multiple gestation. Oxytocin is the preferred medication.
• Controlled cord traction to assist with placental expulsion.
• Uterine massage immediately after placental expulsion, and then as needed.
evidence regarding comparable outcomes with active management versus expectant of the
third stage.
AMTSL has CLEARLY demonstrated the following when AMTSL is used compared with when
expectant management is used to manage third stage of labor: - ANS • A reduced risk of
postpartum hemorrhage
• Less overall blood loss
• Less anemia
• Less need for therapeutic uterotonics
Expectant/Physiologic management of third stage labor - ANS noninterventionist approach
that involves watchful waiting as third stage unfolds spontaneously.
includes no routine uterotonic administration, delayed cord-clamping, and
gentle—if any—cord traction.
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