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Management of the third stage of labor in an Egyptian teaching hospital
Author(s) -
Cherine M.,
Khalil K.,
Hassanein N.,
Sholkamy H.,
Breebaart M.,
Elnoury A.
Publication year - 2004
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2004.05.013
Subject(s) - uterotonic , third stage , medicine , obstetrics , stage (stratigraphy) , childbirth , maternal morbidity , pregnancy , oxytocin , training (meteorology) , paleontology , physics , genetics , meteorology , biology
Objectives : The study describes normal labor practices in an Egyptian teaching hospital for the first time, where postpartum hemorrhage is the leading cause of maternal mortality. Third‐stage management patterns are described and compared to evidence‐based medicine. Reasons for third‐stage practices observed are explored. Study design : 176 normal births were directly observed. Women were interviewed postpartum and study findings were shared with providers. Results : Third‐stage active management was correctly done for 15% of women observed. Most common deviations for the remaining 85% were: giving uterotonic drugs after placental delivery (65%) and without cord traction (49%). Passive management was not done for any observed delivery. Conclusions : The preventive role actively managing the third stage can provide against postpartum hemorrhage was lost to the majority of the deliveries observed. Obstacles to adopting protocols shown to reduce hemorrhage should be explored, given the contribution of postpartum hemorrhage to maternal deaths in Egypt.