Abstract
Introduction: Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. Objective: To assess the practice of AMTSL in four maternity in the commune of Kara (Kara University Hospital Center, Kara Tomde Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabawere Peripheral Care Unit). Method: This was a cross-sectional descriptive study over four months, from January 28 to May 28, 2019. Two questionnaires were used for data collection: an observation and evaluation grid AMTSL practice and a questionnaire for providers. The grid was designed and adapted to the RPC repository model for emergency obstetric and neonatal care in Africa 2018. The data was processed using the Epi Info 7 software. Results: During the study period, 528 parturients were identified and 30 providers surveyed. No provider had received ongoing training in AMTSL. The practice of AMTSL was systematic at each delivery. The practice was correct in 45.8%. Factors associated with incorrect practice were relationship between caregiver-patient (p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p = 0.0001). Conclusion and Suggestion: The practice of AMTSL is systematic, but it was incorrect regardless of the provider’s qualification. Continuing education on AMTSL is necessary to prevent postpartum hemorrhage.
Highlights
Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset
The number of deliveries not benefiting from AMTSL is estimated at 1.4 million, all of which are opportunities to prevent postpartum hemorrhage
AMOUH et al in 2016 at Regional hospital center of Kara found that among patients evacuated for postpartum hemorrhage, only 50.4% had received AMTSL during labor [14]
Summary
Active management of the third period of labor (AMTSL) significantly prevents postpartum hemorrhage onset. It is a set of interventions to speed up the placenta’s delivery by increasing uterine contractions and reducing the number of delivery hemorrhages by three [1]. Additional procedures such as examining the placenta, looking for soft tissue lesions and repairing them, and strict monitoring in the postpartum period are essential to significantly reduce postpartum hemorrhage (PPH) [1] [2] [3]. The number of deliveries not benefiting from AMTSL is estimated at 1.4 million, all of which are opportunities to prevent postpartum hemorrhage. Midwives and nurses are responsible for most deliveries in countries of sub-Saharan Africa [9]
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