Active Management of second and third stage of labour
Management of second stage of labour
Bearing down is encouraged only in the active phase of the second stage, when the
patient feels an urge to bear down.
Monitoring of second stage of labour
1. Foetal heart sounds every 10 minutes in the passive phase and every 5 minutes
in the active phase.
2. Blood pressure and pulse hourly.
3. Vaginal examination after an hour.
4. Frequency of contractions half hourly. Episiotomy should not be performed
routinely.
5. It is performed selectively, in cases with prematurity, foetal distress, breech
presentation, occipito-posterior position, large baby, twin pregnancy or when a
perineal tear is anticipated. It is also performed in all cases of instrumental
delivery.
6. A medio-lateral episiotomy is performed at 45—60 degrees from the midline
directed to the right side, beginning at the vaginal
fourchette. This is carried out at crowning of the head.
Management of Third stage of labour
Active Management of second and third stage of labour
Management of second and third stage of labour: we discuss here management of
second and third stage of labour.Active Management of second and third stage of
labour
1. Oxytocin 5 units (or 0.5 mg of ergometrine) is administered intravenously, with the
delivery of the anterior shoulder. Clamping
of the cord should be delayed for 2 minutes.
2. Once the delivery of the baby is completed, an abdominal examination is performed
to confirm whether the uterus is well contracted.
3. Next controlled cord traction is applied to deliver the placenta.
Copies are from my handwritten notes and encoded for clarity of reading
Management of second stage of labour
Bearing down is encouraged only in the active phase of the second stage, when the
patient feels an urge to bear down.
Monitoring of second stage of labour
1. Foetal heart sounds every 10 minutes in the passive phase and every 5 minutes
in the active phase.
2. Blood pressure and pulse hourly.
3. Vaginal examination after an hour.
4. Frequency of contractions half hourly. Episiotomy should not be performed
routinely.
5. It is performed selectively, in cases with prematurity, foetal distress, breech
presentation, occipito-posterior position, large baby, twin pregnancy or when a
perineal tear is anticipated. It is also performed in all cases of instrumental
delivery.
6. A medio-lateral episiotomy is performed at 45—60 degrees from the midline
directed to the right side, beginning at the vaginal
fourchette. This is carried out at crowning of the head.
Management of Third stage of labour
Active Management of second and third stage of labour
Management of second and third stage of labour: we discuss here management of
second and third stage of labour.Active Management of second and third stage of
labour
1. Oxytocin 5 units (or 0.5 mg of ergometrine) is administered intravenously, with the
delivery of the anterior shoulder. Clamping
of the cord should be delayed for 2 minutes.
2. Once the delivery of the baby is completed, an abdominal examination is performed
to confirm whether the uterus is well contracted.
3. Next controlled cord traction is applied to deliver the placenta.
Copies are from my handwritten notes and encoded for clarity of reading
