Impact of Reorientation and Training of Active Management of the Third Stage of Labor in a New Medical College of Chhattisgarh, India
Shipra Shrivastava, Nalini Mishra
Active management of third stage of labor, Maternal mortality, Postpartum hemorrhage, Visual estimation of blood loss
Citation Information :
Shrivastava S, Mishra N. Impact of Reorientation and Training of Active Management of the Third Stage of Labor in a New Medical College of Chhattisgarh, India. J Mahatma Gandhi Univ Med Sci Tech 2017; 2 (3):138-142.
Active management of third stage of labor (AMTSL) is a best practice that reduces the incidence of postpartum hemorrhage (PPH). The present study was done with an objective to document the prevalent practice in regard to various components of AMTSL and the impact of reorientation session.
Materials and methods
A total 200 women fulfilling the inclusion criteria (low-risk singleton pregnancy at term) and anticipating vaginal delivery were enrolled in the study. In the first stage of the study, observation and documentation of ongoing practice of management of third stage of labor in 100 consecutive women (group I) was followed by reorientation session. In the second stage, again 100 women were observed and documented as above (group II). The changes and its impact in terms of blood loss and incidence of PPH were noted and compared with group I.
None of the women of group I was given injection oxytocin in comparison to 77 women of group II. Controlled cord traction (CCT) was done in 44 women of group I as against 97 of group II women. No significant change in the timing of cord clamping was observed. The PPH occurred in only three women of group II in comparison to 11 of group I (p ≤ 0.05).
The level of adherence to AMTSL was low particularly for the use of oxytocin as first-line prophylactic uterotonic. The change in practice after a session of reorientation was positive and was associated with significant reduction in the incidence of PPH. The study reiterates the importance of frequent trainings.
How to cite this article
Shrivastava S, Mishra N. Impact of Reorientation and Training of Active Management of the Third Stage of Labor in a New Medical College of Chhattisgarh, India. J Mahatma Gandhi Univ Med Sci Tech 2017;2(3):138-142.
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