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Hofmeyr_WHO Trial on Active Management of the Third Stage of Labor

Hofmeyr_WHO Trial on Active Management of the Third Stage of Labor

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Published by Dhaka2012
Justus Hofmeyr (University of the
Witwatersrand and Eastern Cape
Department of Health, South Africa)
Justus Hofmeyr (University of the
Witwatersrand and Eastern Cape
Department of Health, South Africa)

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Published by: Dhaka2012 on May 04, 2012
Copyright:Attribution Non-commercial

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05/04/2012

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AMTSL trial
 ACTIVE MANAGEMENT OF THE THIRDSTAGE OF LABOUR WITHOUT CONTROLLED CORD TRACTION: ARANDOMIZED NON-INFERIORITCONTROLLED TRIALHRP Trial: A65554
Justus Hofmeyr, Presented on behalf of theAMTSL trial Group
 
Rationale
AMTSL reduces PPH by over 60%
AMTSL components are:
administration of oxytocin,
delayed cord clamping,
controlled cord traction (CCT), and
uterine massage.
Previous WHO guidelines recommended AMTSL, but
Acknowledging the lack of evidence on the effectiveness of some individual components.
CCT requires manual skills, carries risks (uterine inversion)
If CCT does not have a meaningful impact on blood loss,then it could be omitted and a simplified package focusingmainly on the uterotonic could be recommended.
 
Uterine inversion being reduced with saline(
O’Sullivan’s
method)

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