Third Stage of Labor

Question 1

third stage

Answer 1

begins with fetal expulsion and ends with placental expulsion

Question 2

What is the average duration of the third stage?

Answer 2

10 mins

Question 3

What is considered prolonged third stage?

Answer 3

> 30mins

Question 4

What are the 2 phases of the third stage?

Answer 4

1) placental separation

2) placental expulsion

Question 5

What are the s/sx of placental separation?

Answer 5

• contractions
• gush of blood
• lengthening of cord
• rise of uterus into abdomen
• uterus becomes firm and rounded

Question 6

How does the placenta separate?

Answer 6

• contractions constrict placental blood vessels –> hemostasis
• uterus abruptly decreases in size
• placental implantation surface area decreases w/out corresponding change in placental size
• sudden discrepancy –> separation

Question 7

Brandt-Andrews maneuver

Answer 7

apply down/upward pressure above symphisis pubis –>

• if cord does not retract, provide more traction to remove placenta
• if cord retracts, WAIT. Separation has not occurred

Question 8

What is active management of the third stage of labor during the second stage?

Answer 8

Pitocin 10u IM when anterior shoulder is delivered

Question 9

Describe the steps of active management of the third stage

Answer 9

1) administer uterotonic agent in second stage
2) gentle cord traction w/ counter pressure on uterus
3) deliver placenta
4) fundal massage AFTER placental expulsion

Question 10

What is an average cord length?

Answer 10

55-60cm