Third Stage Labor UTD Flashcards
What is the third stage of labor?
The time from fetal expulsion to placental delivery.
What is the normal duration of the third stage?
Usually ≤30 minutes.
What are the benefits of delayed cord clamping in term infants?
Higher iron stores, improved hemoglobin levels.
What are the benefits of delayed cord clamping in preterm infants?
Reduced mortality, improved cardiovascular transition.
What is a contraindication for delayed cord clamping?
Monochorionic twins, fetal/maternal instability, abnormal umbilical insertion.
What are risks of delayed cord clamping?
Increased hyperbilirubinemia, potential polycythemia in SGA infants.
What is cord milking?
Manual squeezing of cord to transfuse blood when clamping is not delayed.
What is a risk of cord milking in <28 week infants?
Increased risk of severe intraventricular hemorrhage.
What is physiological cord clamping?
Clamping after spontaneous respirations or cord pulsation cessation.
What is umbilical nonseverance?
Practice of not clamping/cutting cord, allowing it to fall off naturally.
What are risks of umbilical nonseverance?
Infection, loss of placenta for histology, no proven benefit.
What does active management of the third stage include?
Uterotonic agent, controlled cord traction, optional uterine massage.
What is the most important step in managing third stage?
Administration of uterotonic agent (usually oxytocin).
What are signs of placental separation?
Gush of blood, cord lengthening, firm/globular uterus moving cephalad.
How is the placenta expelled?
Spontaneous uterine contraction, retroplacental hematoma, maternal effort.
What is controlled cord traction?
Gently pulling clamped cord while stabilizing uterus to deliver placenta.
What is average blood loss at vaginal birth?
<500 mL with prophylaxis.
What methods assess postpartum bleeding?
Quantitative (calibrated drapes, weighing); subjective visual less accurate.
What structures are checked for lacerations?
Cervix, vagina, perineum, rectum.
What is the purpose of a second rectal exam post-repair?
To detect inadvertent rectal mucosa sutures.
What are benefits of skin-to-skin contact?
Improves thermal regulation, promotes breastfeeding, supports bonding.
Does placing the newborn on the abdomen affect transfusion?
No, position does not alter volume of placental transfusion.
What newborn care steps are done in delivery room?
Vitamin K, eye ointment, Hep B vaccine, screening.
What practices should be avoided?
Water birth, vaginal seeding, lotus birth, placentophagy, delayed bathing with HSV.
