Care of the 3rd Stage

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 oxytocin drug, sytometrine/ syntocin
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 approaches the umbilicus

Question 4

What are the maternal observations during 3rd Stage?

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 3rd Stage?

Answer 5

Colour, respiration, tone

Question 6

What are the complications of 3rd Stage?

Answer 6

PPH, retained placenta, and uterine inversion

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