Active versus expectant management of the third stage of labor in rural Ghana
Geelhoed, D.; Visser, L.; Agordzo, P.; Asare, K.; van Leeuwen, J.Schagen.; van Roosmalen, J.
Acta Obstetricia et Gynecologica Scandinavica 81(2): 172-173
2002
ISSN/ISBN: 0001-6349 PMID: 11942910 DOI: 10.1034/j.1600-0412.2002.810215.xDocument Number: 251360
In Berekum, Ghana, expectant management of the 3rd stage of labour was practiced until 1996. Routine active management (10 IU oxytocin intramuscularly after birth of the baby, early cord clamping and controlled cord traction) was introduced at the start of 1996. Retrospectively, all women who gave birth vaginally in the hospital between 1 January 1992 and 1 January 1999, were included. There were 5088 women in the expectant management group and 3840 women in the active management group. Postpartum haemorrhage (blood loss at delivery of >=500 ml) occurred less often in the active management group (13.7%; n=527) than in the expectant management group (17.4%; n=885) (odds ratio (OR), 0.8; 95% confidence interval (CI), 0.7-0.9). Manual removal of the placenta (done when spontaneous expulsion of placenta was delayed by >one h or when severe bleeding occurred) occurred less frequently in the active management group (2.6%; n=101) than in the expectant management group (3.5%; n=176) (OR, 0.8; 95% CI, 0.7-1.0). Maternal mortality due to postpartum haemorrhage remained unchanged.