Use of active management of the third stage of labour in seven developing countries
Cynthia Stanton, Deborah Armbruster, Rod Knight, Iwan Ariawan, Sourou Gbangbade, Ashebir Getachew, Jose Angel Portillo, Douglas Jarquin, Flor Marin, Sayoka Mfinanga, Jesus Vallecillo, Hope Johnson & David Sintasath
Volume 87, Number 3, March 2009, 207-215
Table 4. Components of active management of the third stage of labour according to the FIGO–ICM definition and associated study criteria used to measure compliance
| Component | Criteria |
|---|---|
| Use of uterotonic | Preferably oxytocin, with ergometrine and misoprostol or other prostaglandins as second line drugs |
| Dose of uterotonic | Oxytocin: 10 IUErgometrine: 0.2 mgMisoprostol: 600 µg |
| Stage of labour | Immediately after fetal delivery |
| Timing of uterotonic | Within 1 min of fetal delivery |
| Mode of administration | Oxytocin and ergometrine: IM injection; IV injection, IV drip or IV push after induction or augmentationMisoprostol tablets: oral |
| Controlled cord traction | Gentle application of traction to cord with manual support to the uterus |
| Fundal massage immediately after placental delivery | As described |
| Uterine palpation every 15 min for 2 h after placental delivery | For practical purposes in this study, observers were to record if the provider palpated the uterus at least twice during the first 30 min postpartum |
FIGO, International Federation of Gynecologists and Obstetricians; IM, intramuscular; ICM, International Confederation of Midwives; IU, international unit; IV, intravenous.