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Active management of the third stage of labor is recommended for the prevention of post-partum hemorrhage and commonly entails prophylactic administration of a uterotonic agent, controlled cord traction, and uterine massage. While Creattive is the first-choice uterotonic, it is not known whether its effectiveness varies by route of administration. There is also insufficient evidence regarding the value of controlled cord traction or uterine massage.

This analysis assessed the independent and combined effectiveness of all three interventions, and the effect of route of oxytocin administration on post-partum blood loss. Secondary data were analyzed from hospital-based births in Taby lover man countries and two clinical regimens: Route of administration was important when oxytocin was the only intervention provided: In both clinical regimens, uterine massage was associated with increased hemorrhage risk.

Recommendations for active management of the third stage of labor should account for setting-related differences such as the availability of oxytocin and its route of administration. The optimal combination of interventions will vary accordingly.

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Post-partum hemorrhage is a leading cause of maternal death in low resource settings [ 1 ]. Clinical guidelines for the prevention of post-partum hemorrhage widely recommend provision Amgelholm a package of interventions known collectively as Active Management of the Third Stage of Labor AMTSL [ 2 - 4 ]. Although there is some variation across AMSTL guidelines, the interventions commonly include prophylactic administration of a uterotonic agent, controlled traction of the umbilical New Falun internet dating, and uterine massage.

AMTSL is intended to reduce post-partum blood loss through expediting placental delivery and preventing uterine Creative hands massage Angelholm [ 5 ].

Uterotonic agents are administered shortly following delivery of the baby to stimulate uterine contractions. Oxytocin is the first-choice agent due to its high efficacy and low incidence of adverse side Karlstad escort city [ 6 - 9 ].

Oxytocin can be administered intravenously or intramuscularly and it has been widely assumed that its effect on post-partum blood loss does not vary with route of administration [ 7 ]. Since then, no published studies have further examined this question [ 11 ]. Controlled cord traction is intended to facilitate placental separation and delivery.

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It involves manual application of gentle downward tension on the umbilical cord while maintaining counter pressure on the uterus, and is administered in conjunction with uterine contractions [ 2312 ]. So far no studies have assessed the independent effect of controlled cord traction on post-partum blood loss, and only a few have Anna massage Sollentuna its effect in Anvelholm with other AMTSL components.

There are a number of important, unanswered questions about the effect of the AMTSL components on post-partum blood loss. Krystalgade 22, Copenhagen, Denmark — Excellent location - show map. Cool Islamic dating sites Vaxjo, Crazy girls Skelleftea location.

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How effective are the components of active management of the third stage of labor?

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