Practice of Active Management of the Third Stage of Labor (AMTSL) Among Parturients at the Community Health Center of Sibiribougou in Commune Iv of the Bamako District

Abstract

Introduction: Active Management of the Third Stage of Labor (AMTSL) consists of a range of interventions aimed at facilitating placental expulsion by increasing uterine contractions and preventing postpartum hemorrhage (PPH) by avoiding uterine atony. Its usual components include uterotonics administration, controlled cord traction, and uterine massage after placental expulsion [1]. The objective of this study was to assess the practice of Active Management of the Third Stage of Labor (AMTSL) among parturients at the Sibiribougou Community Health Center (CS Com). Methodology: This was a descriptive cross-sectional study conducted at the Sibiribougou CS Com from October 11th to November 11th, 2022, for a period of 1 month. The study population consisted of all women in labor and the healthcare providers involved in their care. A total of 101 parturients and 17 healthcare providers were included. Results: The age group of 20 to 30 years was the most represented among parturients, accounting for 54.5% of cases. The mean age was 23.17 years, with a standard deviation of 4.33 years and ranging from 17 to 35 years. The majority of women were married, accounting for 95.05% of cases. Most women were pauciparous, accounting for 55.4% of cases. In 100% of cases, oxytocin was administered within a minute after fetal expulsion, and 75% of injections were correctly performed according to AMTSL standards. Controlled cord traction was performed in 96.3% (97) of cases. It's worth noting that out of the 97 cases, this exercise was done correctly in 67.1% of cases, which corresponds to 65 parturients. In most cases, uterine massage was performed immediately, accounting for 85.1% of cases. In conclusion, the practice of AMTSL is systematic in the delivery room of the CS Com. However, the quality of AMTSL practice remains insufficient, as among the assessed steps, only oxytocin administration was performed in all cases, and only 75% of these were done correctly.