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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Active management of third stage of labor: Evidence versus practice Active management of third stage of labor O.T. Oladapo et al.
Acta Obstetricia et Gynecologica Scandinavica, Volume 88, No. 11, Year 2009
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Description
Objective. To determine the correct use of active management of third stage of labor (AMTSL) (using the full complement of existing standard definitions) and compare the outcomes of third stage of labor in women who received AMTSL (according to these definitions) with those who did not. Design. Observational, cross-sectional survey. Setting. Seven tertiary centers in southwest Nigeria. Population. Women undergoing non-instrumental vaginal deliveries. Methods. Prospective direct observations of childbirth procedures. AMTSL was defined according to Cochrane review, ICM/FIGO (International Confederation of Midwives/International Federation of Gynecology and Obstetrics), and WHO (World Health Organization) recommendations. Main outcome measures. Use of AMTSL and its components and outcome of third stage of labor. Results. There was a high rate of compliance with most of the individual components of AMTSL. The use of AMTSL varied widely with the definition applied and tended to decrease with increasing strictness of the criteria (Cochrane review: 88.9%; ICM/FIGO: 42%; WHO: 1.8%). The frequencies of adverse labor outcomes were generally low (postpartum hemorrhage (PPH): 4.9%; severe PPH: 0.8%; retained placenta: 1.9%; uterine inversion: 0.0%). Frequencies of PPH, postpartum anemia, and mean blood loss among women who received AMTSL according to the Cochrane review definition were significantly lower than for those who did not (p < 0.05). There was no significant difference between any of the outcomes for women who received AMTSL according to the ICM/FIGO definition and those who did not. Conclusions. The survey reveals substantial definition-dependent variation in the providers' adherence to recommended AMTSL practices. The clinical implications of the current practice in this population suggest the need for randomized comparison of various AMTSL packages to determine their comparative effectiveness in the prevention of PPH. © 2009 Informa UK Ltd.
Authors & Co-Authors
Oladapo, Olufemi Taiwo
Nigeria, Ago-iwoye
Olabisi Onabanjo University
Akinola, Oluwarotimi Ireti
Nigeria, Lagos
Lagos State University Teaching Hospital
Fawole, Adeniran Olubukola
Nigeria, Ibadan
University College Hospital, Ibadan
Adeyemi, Adewale Samson
Nigeria, Osogbo
Lautech Teaching Hospital
Adegbola, Omololu
Nigeria, Lagos
University of Lagos
Loto, Olabisi Morebise
Nigeria, Ife
Obafemi Awolowo University Teaching Hospitals Complex
Fabamwo, Adetokunbo Olusegun
Nigeria, Lagos
Lagos State University Teaching Hospital
Alao, Moses O.
Nigeria
Federal Medical Centre Nigeria
Sotunsa, John Obafemi
Nigeria, Ago-iwoye
Olabisi Onabanjo University
Statistics
Citations: 9
Authors: 9
Affiliations: 7
Identifiers
Doi:
10.3109/00016340903280958
ISSN:
00016349
e-ISSN:
16000412
Research Areas
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative
Study Locations
Nigeria
Participants Gender
Female