Management of the Third Stage Of Labor: An Evidence‐Based Approach
- 12 November 2001
- journal article
- review article
- Published by Wiley in Journal of Midwifery & Women's Health
- Vol. 46 (6) , 381-392
- https://doi.org/10.1016/s1526-9523(01)00192-1
Abstract
The third stage of labor usually is eclipsed by the excitement of the birth of a baby. Evidence shows that management of this stage can directly influence important maternal outcomes such as blood loss, need for manual removal of the placenta, and postpartum hemorrhage. Most of the large trials have compared active management of the third stage to expectant management. Active management includes routine use of cord traction and uterotonins, whereas expectant management can be characterized as one of watchful waiting. The use of herbal therapies and homeopathic remedies lack study; additional factors such as site of birth and hydrotherapy also remain to be explored. However, on the basis of current evidence, if a decrease in postpartum bleeding or avoidance of manual removal is desired, an active approach to third stage is the one that should be adopted until and unless contradictory findings are published.Keywords
This publication has 33 references indexed in Scilit:
- Complicated third stage of labor: time to switch on the scannerUltrasound in Obstetrics & Gynecology, 2000
- Drugs Uterine MotilityJournal of Obstetric, Gynecologic & Neonatal Nursing, 1999
- Oral misoprostol for third stage of labor: a randomized placebo-controlled trialObstetrics & Gynecology, 1999
- A prospective cohort study of oxytocin plus ergometrine compared with oxytocin alone for prevention of postpartum haemorrhageBJOG: An International Journal of Obstetrics and Gynaecology, 1996
- The Effect of Intraumbilical Oxytocin on the Third Stage of LabourAustralian and New Zealand Journal of Obstetrics and Gynaecology, 1996
- Correlation of Total Uterine Activity to Blood Loss in the Third Stage of LabourGynecologic and Obstetric Investigation, 1996
- Third stage of labor: Analysis of duration and clinical practiceAmerican Journal of Obstetrics and Gynecology, 1995
- A simple alternative to parenteral oxytocics for the third stage of laborInternational Journal of Gynecology & Obstetrics, 1994
- Management of retained placenta using intraumbilical oxytocin injectionJournal of Nurse-Midwifery, 1991
- EARLY SUCKLING AND POSTPARTUM HAEMORRHAGE: CONTROLLED TRIAL IN DELIVERIES BY TRADITIONAL BIRTH ATTENDANTSThe Lancet, 1989