THIRD STAGE

of LABOR
Post-Graduate Interns
Third stage of labor
Signs of Placental Separation
Mechanisms of Placental Delivery
Why do active management?
Active Management
of the
3rd Stage of Labor
 Administration of Uterotonic
drug within 1 min of delivery of
baby

Delivery of Placenta by
Controlled Cord Traction (CCT)

Uterine Massage
 Oxytocin
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Alternatives:
Methylergonovine
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Alternatives:
Prostaglandins
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 Delivery of Placenta by
Controlled Cord Traction (CCT)
Signs of Placental Separation
 Delivery of Placenta by
Controlled Cord Traction (CCT)
 Uterine Massage

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Complications of the
3rd Stage of Labor
POSTPARTUM HEMORRHAGE
SHOCK

RETAINED PLACENTA

PULMONARY / AF EMBOLISM

UTERINE INVERSION
POSTPARTUM HEMORRHAGE
POSTPARTUM HEMORRHAGE
 Management of PPH secondary to Atonic
Uterus
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RETAINED PLACENTA
Management of Retained Placenta

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UTERINE INVERSION
 Management of Uterine Inversion
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PULMONARY / AF EMBOLISM
Management of Pulmonary / AF Embolism

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Thank you