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VOLUME 5 , ISSUE 1 ( January-March, 2019 ) > List of Articles


A Clinical Audit of Intrapartum Care in Third Stage of Labor

Harshitha S, MPA Sailakshmi

Keywords : NICE guidelines, PPH, Uterotonics

DOI: 10.5005/jp-journals-10045-00108

License: CC BY-NC 4.0

Published Online: 01-03-2019

Copyright Statement:  Copyright © 2019; The Author(s).


Introduction: The third stage of labor is the time from the birth of the baby to the expulsion of the placenta and membranes. Management are normally categorized into two types; active management and physiological management. Active management of the third stage involves a package of care comprising the following components: routine use of uterotonic drugs, deferred clamping and cutting of the cord controlled cord traction after signs of separation of the placenta. Most common complications of third stage of labor are postpartum hemorrhage and retained placenta. Aims and objectives: The present clinical audit aims to improve the care of healthy women and their babies during the third stage of child and to review the practices regarding the third stage of labor and to develop and implement action plan regarding management strategies. Materials and methodology: The audit was carried out on 218 pregnant women admitted in RajaRajeswari Medical College and Hospital from April 2018 to September 2018. The inclusion criteria, exclusion criteria and data collection on excel sheet were based on NICE guidelines. Results: Among 218 cases, vaginal blood loss was recorded in 181(83%) cases whereas the color, respiration and general condition was recorded in all 218 cases. Active management of third stage was carried out and decision regarding the same was recorded in all 218 cases. The time of cord clamping was recorded in only 6% of the cases. The management of PPH and retained placenta met audit standard in all 218 cases. Conclusion and recommendations: The present clinical audit suggests that there is a need to follow specific guidelines and treatment strategies to avert the complications. Recording of vaginal blood loss in all cases, instructions for compulsory recording of the cord clamping time following birth of baby and continue to follow the remaining steps according to NICE guidelines to reduce the complications of third stage of labor.

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