active management 3rd stage

Question 1

2 options for 3rd stage manaegement

Answer 1

physiological Mx

active Mx

Question 2

physiological mx

Answer 2

placenta is delivered by maternal effort w/o medications or cord traction

Question 3

when is active management offered

Answer 3

offered to all women to reduce risk PPH

Question 4

when is active Mx initated

Answer 4

haemorrhage

> 60min delay in delivering placenta

Question 5

Steps of active Mx - oxytocin

Answer 5

IM dose of oxytocin (10IU) after delivery of baby

Question 6

Steps of active Mx - cord clamping

Answer 6

cord is clamped and cut within 5min of birth

there should be 1-3min delay to allow blood flow to baby

Question 7

steps of active Mx- cord traction

Answer 7

palpate abdo to assess for uterine contraction
controlled cord traction is applied during contraction and is stopped if resistance

other hand presses uterus upwards to prevent uterine prolapse

Question 8

after delivery

Answer 8

massage uterus until contracted and firm

examine placenta to ensure it is complete and no tissue remaining in uterus