TY - JOUR
T1 - The effect of guideline variations on the implementation of active management of the third stage of labor
AU - Miranda, Jezid E.
AU - Rojas-Suarez, Jose
AU - Paternina, Angel
AU - Mendoza, Ray
AU - Bello, Camilo
AU - Tolosa, Jorge E.
PY - 2013/6
Y1 - 2013/6
N2 - Objective To determine whether healthcare providers performed active management of the third stage of labor (AMTSL) as defined by FIGO/ICM and WHO, and as described by the Cochrane Collaboration. Methods In a prospective observational study, a questionnaire regarding knowledge of AMTSL was administered to healthcare providers in the largest maternity teaching center in Colombia. It was subsequently observed whether and how the healthcare providers performed AMTSL in practice. The percentage of correct use of AMTSL was calculated. Results Healthcare providers indicated they knew what AMTSL was but disagreed on the timing of prophylactic oxytocin use. In total, 241 deliveries were observed. Oxytocin at varying doses and routes was used in 239 (99.2%) deliveries. In all deliveries, the umbilical cord was clamped early. In 49 (20.3%) deliveries, controlled cord traction was performed. Uterine massage was carried out in 213 (88.4%) deliveries. According to the FIGO/ICM and WHO definitions, and the Cochrane Collaboration description, correct use of AMTSL occurred in 0.8%, 0.0%, and 8.3%, of cases, respectively. Conclusion Correct use of AMTSL is low at the largest maternity teaching center in Colombia. There is an urgent need for a single definition of AMTSL, which could be used globally for research, training, and scaling-up the performance of AMTSL.
AB - Objective To determine whether healthcare providers performed active management of the third stage of labor (AMTSL) as defined by FIGO/ICM and WHO, and as described by the Cochrane Collaboration. Methods In a prospective observational study, a questionnaire regarding knowledge of AMTSL was administered to healthcare providers in the largest maternity teaching center in Colombia. It was subsequently observed whether and how the healthcare providers performed AMTSL in practice. The percentage of correct use of AMTSL was calculated. Results Healthcare providers indicated they knew what AMTSL was but disagreed on the timing of prophylactic oxytocin use. In total, 241 deliveries were observed. Oxytocin at varying doses and routes was used in 239 (99.2%) deliveries. In all deliveries, the umbilical cord was clamped early. In 49 (20.3%) deliveries, controlled cord traction was performed. Uterine massage was carried out in 213 (88.4%) deliveries. According to the FIGO/ICM and WHO definitions, and the Cochrane Collaboration description, correct use of AMTSL occurred in 0.8%, 0.0%, and 8.3%, of cases, respectively. Conclusion Correct use of AMTSL is low at the largest maternity teaching center in Colombia. There is an urgent need for a single definition of AMTSL, which could be used globally for research, training, and scaling-up the performance of AMTSL.
KW - Colombia
KW - Controlled cord traction
KW - Cord clamping
KW - Postpartum hemorrhage
KW - Vaginal deliveries
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U2 - 10.1016/j.ijgo.2012.12.016
DO - 10.1016/j.ijgo.2012.12.016
M3 - Article
C2 - 23528800
AN - SCOPUS:84876938979
SN - 0020-7292
VL - 121
SP - 266
EP - 269
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 3
ER -