Mx of 3rd stage of labour

Question 1

When should labour be actively managed?

Answer 1

1. Haemorrhage

2. Failure to delivery placenta within 1 hour

Question 2

What is the first intervention of managment

Answer 2

Syntometrine/Oxytocin IM is given as the anterior shoulder of the baby is born

Question 3

Second intervention of Mx

Answer 3

Controlled chord traction applied with right hand whilst supporting fundus with left
Brandt-Andrew’s techniqu

Question 4

What does the active management of the third stage of labour involve?

Answer 4

Use of oxytocic drugs prophylactically

Controlled cord traction to deliver placenta (Brandt-Andrews method)

Clamping and cutting umbilical cord

Question 5

What is the oxytocic drug that we commonly use prophylactically in the active management of the third stage of labour?

Answer 5

IM syntometrine - 5 units of syntocinon and 0.5mg ergometrine

Question 6

What is the contraindication to using syntometrine as part of active management of the third stage of labour? What is given instead?

Answer 6

Hypertension

Syntocinon is given instead