Active management of the third stage of labour.

Active versus expectant management of the third stage of labour.

BACKGROUND Expectant management of the third stage of labour involves allowing the placenta to deliver spontaneously or aiding by gravity or nipple stimulation. Active management involves administration of a prophylactic oxytocic before delivery of the placenta, and usually early cord clamping and cutting, and controlled cord traction of the umbilical cord. OBJECTIVES The objective of this re...

The Bristol third stage trial: active versus physiological management of third stage of labour.

OBJECTIVE To compare the effects on fetal and maternal morbidity of routine active management of third stage of labour and expectant (physiological) management, in particular to determine whether active management reduced incidence of postpartum haemorrhage. DESIGN Randomised trial of active versus physiological management. Women entered trial on admission to labour ward with allocation revea...

Active versus expectant management of third stage of labour.

BACKGROUND This study tested the hypotheses that active management of the third stage of labour lowers the rates of primary postpartum haemorrhage (PPH) and longer-term consequences compared with expectant management, in a setting where both managements are commonly practised, and that this effect is not mediated by maternal posture. BACKGROUND 1512 women judged to be at low risk of PPH (bloo...

Management of third stage of labour.

Does active management of the third stage of labour confer any benefits over expectant management? A Cochrane review of 7 studies in 8247 women (Begley, 2011) found “The evidence suggested that for women at mixed levels of risk of bleeding, active management showed a reduction in the average risk of maternal primary haemorrhage at time of birth (more than 1000 mL) (average risk ratio (RR) 0.34,...

Discussion on the Management of the Third Stage of Labour