Care in 3rd stage labour

Question 1

What is physiological management ?

Answer 1

No use of drugs
no clamping or cutting of cord
await signs of separation- cord lengthening, small gush of blood per vagina
strong urge to push may be present
placenta and membranes delivered by maternal effort

Question 2

What is active management?

Answer 2

Administration of a oxytocic drug, sytometrine/ syntocinon
clamping and cutting of cord
controlled cord traction (CCT)

Question 3

What are the sign of separation of the placenta?

Answer 3

a sudden gush of blood (larger in physiological management)
Lengthening of the visible portion of the umbilical cord
The uterus becomes round and firm
The uterus enlarges and approaches the umbilicus

Question 4

What are the maternal observations during stage 3?

Answer 4

physical condition of mother
if prolonged stage 3 then maternal pulse and BP every 15 minutes
vaginal blood loss

Question 5

What are the baby observations in stage 3?

Answer 5

colour, respiration, tone

Question 6

What are the risks on stage 3?

Answer 6

Postpartum haemorrhage: one of the four major causes of maternal death globally
ensure placenta and membranes are complete
be vigilant is estimated blood loos in bigger than 500ml

Question 7

What is appropriate after care?

Answer 7

Check placenta and membranes are complete
Inspection of perineum,, vagina and labia for trauma- repair if required
maternal observations
documentation