Duration Of Third Stage Research Articles

Assisted reproductive technology and prolonged third stage of labour: a multicentre study in Japan

Research questionWhat are the risk factors for a prolonged third stage of labour, closely related to postpartum haemorrhage, and what is the effect of assisted reproductive technology (ART) on the third stage of labour? DesignClinical data of women who delivered vaginally at term at 12 primary maternity hospitals in Japan (2010–2018) (n = 25,336) were obtained; 1148 (4.5%) conceived through ART and 2246 (8.9%) through non-ART treatments. The risk of a prolonged third stage of labour (defined as ≥20 min) was evaluated by univariable and multivariable regression analyses. Adjusted odds ratios (aOR) of a prolonged third stage of labour were evaluated, stratified by the type of ART, with natural conception as a reference. ResultsMultivariable analysis showed that pregnancy achieved through ART (aOR 4.38, 95% CI 3.12 to 6.15), history of spontaneous miscarriage (OR 1.40, 95% CI 1.06 to 1.84) and prolonged labour (OR 1.52, 95% CI 1.09 to 2.12) were identified as independent risk factors. Frozen embryo transfer (FET), FET in a hormone replacement cycle (HRC–FET) and blastocyst-stage embryo transfer were significantly associated with a prolonged third stage of labour (aOR 4.07, 95% CI 2.75 to 6.04, aOR 4.11, 95% CI 2.58 to 6.57 and aOR 2.13, 95% CI 1.15 to 3.95, respectively). No significant difference was observed in the duration of third stage of labour between natural conception and non-ART treatment (P = 0.61). ConclusionPregnancy achieved through ART, particularly FET, HRC–FET and blastocyst-stage embryo transfer, was a significant risk factor for a prolonged third stage of labour.

Comparison of Mean Duration of Third Stage of Labor with Oral Misoprostol versus Intramuscular Oxytocin

Comparison of Mean Duration of Third Stage of Labor with Oral Misoprostol versus Intramuscular Oxytocin

Effectiveness of Pelvic Rocking Exercise with Birth Ball on the Duration of Third Stage of Labor

The method involving pelvic rocking exercises using a birth ball combined with acupressure represents a strategy in midwifery aimed at easing tension in the pelvic muscles, beneficial for shortening the length of labor, particularly in its third stage. This approach significantly enhances uterine contractions by prompting the pituitary gland to release oxytocin, thereby aiding in the swift expulsion of the placenta. The objective of this study is to evaluate the comparative effectiveness of pelvic rocking exercises with a birth ball and SP6 acupressure on shortening the third stage of labor. The Research design was Quasi-Experimental with Two Group Comparison, and the research was conducted in a maternity clinic in East Jakarta. The Respondents of this study were women in the active phase of the first stage of Labor. Participants and Sampling Technique: The total sample size was 64 respondents, divided into two groups of 32 each. The initial group underwent an intervention involving pelvic rocking exercises using a birth ball, whereas the second group was treated with SP6 acupressure. The method of selection used was purposive sampling, enabling the investigators to choose subjects according to predefined eligibility criteria. The Results were analyzed using bivariate analysis with the Mann-Whitney U test, as all variables were found to have non-normal distributions. The study findings indicated a statistically significant difference in the duration of the third stage of labor between the group that received the pelvic rocking exercise with a birth ball and the group that underwent the Acupressure SP6 intervention, as shown by a p-value of 0.005 (< 0.05). The data analysis demonstrated that the group participating in the pelvic rocking exercise with a birth ball experienced a quicker third stage of labor, with an average rank of 26.38, in contrast to the acupressure SP6 group, which had an average rank of 38.63. Therefore, it can be concluded that employing the pelvic rocking exercise with a birth ball is an effective method for reducing the length of the third stage of labor, proving to be a safe option for expecting mothers.

387 Duration of Third Stage of Labor and Maternal Hemorrhagic Adverse Outcomes

387 Duration of Third Stage of Labor and Maternal Hemorrhagic Adverse Outcomes

Early Suckling and Post-Partum Bleeding

CONTEXT When working with parturient women, particular care must be taken at a sensitive phase like the immediate postpartum period. In order to minimise the quantity of vaginal blood loss, it is crucial to emphasise to those mothers the value of frequent breastfeeding and early start-up. The purpose of this study to investigate the effect of early suckling on postpartum bleeding . CONSTRUCTION A quasi experimental research design was utilized. CONTEXT The study was conducted at labor unit of Obstetrics and Gynecology department in Benha University Hospital. A SELECTED SAMPLE A purposive sample of (100) women's (50) in the group in commandwere given routine care and (50) women in the study squad, women encouraged to initiate early suckling immediately after birth. Tool I): A structured interviewing questionnaire II): Observation record on parturient women during stages of labor III): Breastfeeding assessment tool. there were highly statistically significant differences in duration of third stage of labor was at 5 minutes in women of study squad compared to women in the control group.Also, there were highly statistically significant differences found between the total mean score of the early initiation of breastfeeding among the study squad (10.2800±1.789) compared to (8.4800±2.233) of the group in command. It is possible to educate expectant mothers about the benefits of early breastfeeding at hospitals and birthing facilities.

Head position and vacuum-assisted delivery using the Kiwi Omnicup.

To evaluate the association between fetal head position during prevacuum assessment and adverse outcomes. This retrospective cohort study included all vacuum-assisted deliveries using the Kiwi Omnicup over 5 years. Primary outcomes were third- or fourth-degree perineal tear, pH < 7.1, and subgaleal hematoma (SGH). AGAR, neonatal intensive care unit admission, cephalohematoma, Erb's palsy, third-stage duration, and postpartum hemorrhage were secondary. Outcomes were compared between the occiput posterior (OP) and occiput anterior (OA) positions. The study included 1960 patients. OP position was more likely to involve epidural analgesia (311 [82.5%] vs. 1216 [77%], P= 0.020), higher fetal head station (P= 0.001), higher percentage of cup detachments (121 cases [32.1%] vs. 307 [19.4%], P= 0.001), and longer procedure (5.5 ± 3.7 min vs. 4.7 ± 2.8 min, P= 0.001). OP was associated with umbilical cord pH< 7.1 (21 [5.5%] vs. 52 [3.9%], P= 0.032), NICU admissions (16 [4.2%] vs. 38 [2.4%], P= 0.049), SGH (18 [4.8%] vs. 38 [2.4%], P= 0.013), and high-degree perineal tears (12 [3.2%] vs. 26 [1.7%], with borderline significance, P= 0.051). SGH and high-grade tears remained significantly associated with OP position (P= 0.008 and P= 0.016, respectively) after adjusting for maternal age, nulliparity, diabetes, epidural anesthesia, preprocedure head station, and birth weight. OP position is an independent risk-factor for anal sphincter injury and SGH during vacuum-assisted delivery.

Effect of Placental Cord Blood Drainage on Duration of Third Stage of Labour

Objective: Current study was conducted to explore placental drainage effect on the 3rd stage of labour. Methodology: This randomized controlled clinical trial was directed at normal labour unit at Sahiwal Medical College using non-probability consecutive sampling technique to enroll 112 patients undergoing normal vaginal delivery. Results: This study was conducted from 15th March 2021 till 14th September 2021 after approval of hospital ethical committee. In our study total 112 patients were enrolled and divided in two groups. Mean age of 30.98±4.727 years in PCD group and 32.18±3.298 years in control group. Mean gestational age was 39.187±0.8123 in PCD group and 39.148±0.8123 in control group. Mean pre-delivery hemoglobin levels and hematocrit was also comparable in both groups with p-value more than 0.05. Duration of third stage of labor was significantly shorter in PCD group i.e. 8.53±2.7 minutes as compared to control group i.e. 10.7±5.3 minute, p-value was significant 0.001. There was less blood loss in PCD group, p-value 0.039. post-delivery hematocrit was low in control group, p-value 0.021. There was no relation of age, gender and parity on duration of third stage of labour. Conclusion: Placental Cord Blood Drainage is secure, and effective noninvasive intervention that may help in improving 3rd stage progress. Keywords: Placenta Cord Drainage, Third Stage of Labour, Postpartum Hemorrhage.

Use of Oral Misoprostol in Active Management of the Third Stage of Labour

Background: More than half of all maternal deaths occur within 24 hrs. of delivery and most commonly occur from excessive blood loss. PPH is the most significant direct cause of maternal mortality in low resource countries, accounting for approximately 30% of maternal deaths worldwide and is one of the most preventable. This study finds out to use of oral misoprostol in active management of the third stage of labour. Objective: To use oral misoprostol for active management of the third stage of labour. Method: An Observational cross-sectional study was carried out Obstetrics &amp; Gynaecology indoor Department of BSMMU, from November ‘2013 to April’ 2014, 100 cases were included in this study. Detailed information’s were obtained in each cases according to protocol. Complete history was taken either from patient or accompanying attendants. Thorough clinical examination was done. Relevant investigations report was collected. All the information’s were recorded in the fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS. RESULTS: In present study 100 cases were included, the mean age was 27.64(±4.25) years, minimum age was 20 years and maximum age was 40 years. Twenty seven percent were come from lower socio-economic class, 69% came from middle class and only 04% came from upper socio-economic class. Thirty four percent were primi para, 49% were 1-3 para and 07% were &gt; 3 para. Mean duration of third stage of labour 7.49(±2.82) min. Six percent need additional oxytocics and 94% do not need additional drug. Pre delivery mean systolic blood pressure was 119.3 ±10.4 mm of Hg and mean diastolic blood pressure was 69.57 ± 6.23 mm of Hg. Mean Hb% level was 12.1 ± 1.3 g/dl and minimum level was 7.5 g/dl and 13.8 g/dl. 06% patients had blood loss &gt; 500 ml. No side effects such as vomiting diarrhea. However, shivering occurred 08%, fever 07% and nausea was found 03% patients. ...................

Efficacy of Rectal Misoprostol in Active Management of Third Stage of Labour in Comparison with Oxytocin

Background Third stage of labour is defined as the time from delivery the baby to complete delivery of the placenta and its attached membranes Most common complications of the third stage of labour are postpartum hemorrhage (PPH). Active management of third stage of labour (AMTL) prevents PPH. Misoprostol is a prostaglandin E1 analogue has been suggested as an alternative of the routine prophylactic oxytocic agents in AMTL. Rectal route had been chosen because it avoids gastrointestinal side effects Objectives: To asses effectiveness of (400 mcg) rectally administered misoprostol tablet in the AMTL in comparison with standard oxytocin regimen Patients and Methods In prospective case-control study, 100 women were randomized, 50 patients received either 400mcg misoprostol tablets rectally (study medication) the other 50 received 10 IU oxytocin in 500 ml Ringer lactate solution IV. As a method of AMTL. Patient with risk factor for PPH had been excluded. A comparison between the two groups in their amount of blood loss, drop in hemoglobin level from admission to 24 hr. after delivery, duration of third stage of labour and any side effects appear done Results Maximum amount of blood loss in both groups of the study was 440 ml, so we had no case of PPH. There was no stastically significant difference in mean blood loss, mean difference in Hb level (gm/dl) on admission and 24 hours after delivery, and duration of third stage of labour found between study groups [p values= 0.138, 0.227, 0.08 respectively]. More shivering occurs in cases but the difference was not significant. Conclusions: Misoprostol in a dose of 400 mcg rectally shows promising results, it seems safe and effective drug that can be used in the management of third stage of labour.

Comparing the Effectiveness of Transrectal Misoprostol with Intravenous Oxytocin in Active Management of Third Stage of Labour in Preventing Post-partum Hemorrhage

Background: PPH which is 500 ml or more blood loss in 24 hours of birth . Uterine atony has been the commonest cause of PPH. To prevent PPH uterotonics like oxytocin and misoprostol should be given. Intravenous route of oxytocin has rapid effect, but is associated with cardiovascular side effects like rise in heart rate and decrease in blood pressure. Slower rate of absorption, lower peak levels and reduced adverse effects is seen with misoprostol given rectally when compared to sublingual and oral routes. This study aims to compare the effectiveness of transrectal misoprostol and intravenous oxytocin in preventing post-partum haemorrhage.&#x0D; Objectives: To compare the effectiveness of 600mcg transrectal misoprostol with 10IU intravenous oxytocin in active management of third stage of labour in preventing PPH and recommend technique for active management of third stage of labour in preventing PPH.&#x0D; Methodology: Women randomized into two groups for prevention of PPH and are given 600ug of misoprostol per rectally and 10IU oxytocin intravenously. Duration of third stage, the blood volume in kidney tray and additional blood loss in sterile surgical pads for 24hrs will be noted. The blood loss due to episiotomy will be taken as 50ml.Need of additional uterotonics(oxytocin or misoprostol), blood transfusion, removal of placenta manually, haemoglobin before and after delivery will be noted. Monitoring of patients for vital signs, uterine tone, fundal height and vaginal bleeding for 2 hour will be done.&#x0D; Result: The expected outcome of the study will be a significant difference in the blood loss during third stage of labour and 24 hours in post-partum period when uterotonics like oxytocin or misoprostol are used in managing third stage of labour actively.&#x0D; Conclusion: Our study will show the effect of intravenous oxytocin and transrectal misoprostol in managing third stage of labour actively to prevent post-partum hemorrhage.

Effect of Umbilical Cord Milking on Maternal and Neonatal Outcomes in a Tertiary Care Hospital in South India: A Randomized Control Trial.

Umbilical cord milking (UCM) has been theorized to increase placental blood transfusion then again, the optimal method of cord clamping at birth is still contested. We aimed to analyse the effects of UCM on the neonatal haematological parameters at 72h and 6weeks of age and its association with any adverse effects. In this randomized control trial, mothers ≥ 34weeks were randomized into two arms. Under the intervention group, the cord was milked three times before clamping and cutting whereas the controls had the cord clamped and cut without milking. Haemoglobin and haematocrit levels were measured at 72h. and at 6weeks. A total of 170 mothers were enrolled with 85 subjects in each arm. Baseline characteristics were comparable. In the intervention arm, the mean haemoglobin [18.1 (2.4) g/dL] and haematocrit [54 (7) %] were significantly higher as compared to the control arm [16.4 (2.1) g/dL and 48 (6) %], at 72h of age. There was also significant increase in the mean haemoglobin [11.6 (1.3) g/dL] and haematocrit [34 (4) %] compared to the controls [10.1 (1.1) g/dL and 30 (3) %], at 6weeks. No statistical difference was found in the incidence of PPH and duration of third stage. There was no significant rise in hyperbilirubinaemia, phototherapy requirement and polycythaemia among neonates in the intervention group. Umbilical cord milking is a sound practical approach to raise the haemoglobin and haematocrit levels up to 6weeks thereby decreasing the proportion of anaemic infants.

ORAL MISOPROSTOL VERSUS INTRAMUSCULAR OXYTOCIN IN THE ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR

Background: The third stage of labor is defined as the time between the delivery of the baby and delivery of the placenta. The third stage of labor is potentially the most dangerous part for the mother. The main risk is the occurrence of postpartum hemorrhage. Objective: To compare the efficacy and safety of oral misoprostol with intramuscular oxytocin in the active management of third stage of labor for the prevention of postpartum hemorrhage. Patient and Methods: The study was conducted in the labor ward of Obstetrics and Gynecology Department at Imbaba General Hospital from September 2018 till September 2019. This study included four hundred healthy pregnant women during the course of normal labor. Patients in this study were randomly divided into two equal groups: Group (I) received 600 mcg Misoprostol orally within 1 minute of delivery of the baby and Group (II) received 10 IU oxytocin intramuscularly within 1 minute of delivery of the baby. We compared the two groups using computer programs to evaluate the safety and efficacy of each drug. The primary outcome measure was postpartum fall in haemoglobin after 8 h of delivery. Secondary outcome measure was duration of third stage of labor, need for an additional uterotonic drug, need for blood transfusion and side effects of both the drugs. Results: There was no significant difference between the two groups regarding the duration of the third stage of labor, the change in hemoglobin and hematocrit levels from before labor to 8 hours postpartum, and the occurrence of complications (the need for more utrotonic drugs and the need for blood transfusion). As regard the duration of third stage of labor, there was a slight advantage for the oxytocin group over the misoprostol group, 4% of cases in oxytocin group have side effects, while 13% of cases in misoprostol group have sides effects in the form of nausea, vomiting, fever, shivering. Conclusions: No major difference in oral misoprostol and intramuscular oxytocin in the management of third stage of labor.

ORAL MISOPROSTOL VERSUS INTRAMUSCULAR OXYTOCIN IN THE ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR

Background: The third stage of labor is defined as the time between the delivery of the baby and delivery of the placenta. The third stage of labor is potentially the most dangerous part for the mother. The main risk is the occurrence of postpartum hemorrhage. Objective: To compare the efficacy and safety of oral misoprostol with intramuscular oxytocin in the active management of third stage of labor for the prevention of postpartum hemorrhage. Patient and Methods: The study was conducted in the labor ward of Obstetrics and Gynecology Department at Imbaba General Hospital from September 2018 till September 2019. This study included four hundred healthy pregnant women during the course of normal labor. Patients in this study were randomly divided into two equal groups: Group (I) received 600 mcg Misoprostol orally within 1 minute of delivery of the baby and Group (II) received 10 IU oxytocin intramuscularly within 1 minute of delivery of the baby. We compared the two groups using computer programs to evaluate the safety and efficacy of each drug. The primary outcome measure was postpartum fall in haemoglobin after 8 h of delivery. Secondary outcome measure was duration of third stage of labor, need for an additional uterotonic drug, need for blood transfusion and side effects of both the drugs. Results: There was no significant difference between the two groups regarding the duration of the third stage of labor, the change in hemoglobin and hematocrit levels from before labor to 8 hours postpartum, and the occurrence of complications (the need for more utrotonic drugs and the need for blood transfusion). As regard the duration of third stage of labor, there was a slight advantage for the oxytocin group over the misoprostol group, 4% of cases in oxytocin group have side effects, while 13% of cases in misoprostol group have sides effects in the form of nausea, vomiting, fever, shivering. Conclusions: No major difference in oral misoprostol and intramuscular oxytocin in the management of third stage of labor.

Study on parturition of beef cattle in small holder farm: stage, placental weight, and placentomes

Scientific data on the length of parturition stage, placental weight, and the number of placentomes in Ongole (PO), Simental Ongole (SimPO), Limosin and Ongole (LimPO) breeds in Yogyakarta Province are not yet known. This research aimed to study parturition stage, placental weight, and placentomes number on beef catlle in small holder farm. This research was carried out on small farmers in the Special Region of Yogyakarta Province. There were 22 PO, 7 simpo, and 4 limpo cattle. The first study determined length stage of parturition. The second study determined the weight of the placenta and the number of placentomes. Data collected were analyzed descriptively. The results of first stage in PO, SimPO, and LimPO cattle were 73.7, 44.5, and 62. 9 hours. The duration of second stage in PO, SimPO, and LimPO cattles were 58.1, 78.7, and 24.5 minutes. The duration of third stage in PO, SimPO, and LimPO cattle were 4.3, 4.8, and 3.5 hours. The placenta weight in PO and SimPO cattle showed that the average of placenta weight was 4.1 and 3.6 Kg. The number of placentomes in PO, SimPO, dan LimPO cattle were 92.5, 92.8, and 102.6. This research showed that the average of stage I in PO was longer than SimPO and LimPO, stage II and stage III in SimPO was longer than PO and LimPO. In addition, the average of placenta weight in PO was heavier than SimPO and LimPO cows. The average number of placentomes in LimPO was higher than PO and SimPO cattle.

A comparative study of efficacy of rectal misoprostol with intravenous methyl ergometrine and intramuscular PGF2a in active management of third stage of labor

PPH is almost entirely a preventable condition when management is based on scientifically proven methods. It occurs in approximately 4% of vaginal deliveries, and estimates are that it causes significant morbidity and 25% of all the maternal child birth related deaths. We conducted this study with the following aims to compare the effectiveness of rectal misoprostol (600mcg) with intravenous methylergometrine (0.2mg) and intramuscular PGF2α (125mcg). To find out the percentage of pregnant women having postpartum hemorrhage, amount of blood loss and efficacy and safety of uterotonic drugs during third stage of labor. Patients with full-term singleton pregnancy in the age group of 20-35 years admitted in the maternity ward for vaginal delivery were enrolled in the study after taking written informed consent. The third stage of labor was actively managed in these patients by either 600mcg of misoprostol per rectally (Group A) or 0.2mg of IV methylergometrine (Group B) or 125mcg of PGF2α intramuscularly (Group C) and some were given any prophylactic oxytocic (Group D). Majority 110 (55%) of the studies participants were in the age group of 20-24 years. Moreover, 109 (54.5%) belonged to upper middle (II) socioeconomic class as per modified Kuppuswamy’s socioeconomic scale update for 2018. Only, 7 (3.5%) of the participants were grand multipara’s while 24 (12%) had gestational age greater than 40 weeks. Mean maternal age, gestational age and duration of third stage of labor was comparable in all the study groups. Maximum amount of blood loss was seen among participants who were in control group (201.80 ± 122.81 ml) and the maximum ‘mean difference in Hb’ was also seen in control group (0.83 gm%). Reported side effects during the study included diarrhea, nausea, shivering and vomiting in (1.5%) participants. Postpartum hemorrhage and retained placenta was reported among 7 (3.5%) and 2 (1%) participants only.Misoprostol can be used as a safe and effective alternative agent in active management of third stage of labor.

A STUDY TO ASSESS THE EFFECTIVENASS OF IMMEDIATE BREAST FEEDING ON DURATION OF THIRD STAGE OF LABOUR AND BLOOD LOSS DURING THE SAME IN SELECTED HOSPITALS

An experimental study was conducted to assess the effectiveness of immediate breast feeding on duration of third stage of labour and blood loss during the same in selected hospitals of Pune city. The conceptual framework adopted for the study was General System Model. The sample size was 60 full term mothers in active labour, divided into two groups. Purposive sampling technique was used for selection of sample. Where, Group I is experimental group and Group II is an control group. Each consisted of 30 samples. Data collection was accomplished by using observation check list as a tool. It consists of three sections. First section dealt with demographic profile of the samples. Second section dealt with observation check list to assess duration of labour.Third section dealt with amount of blood loss.Pilot study was conducted to assess the feasibility of the study. It was conducted on 14 mothers.Final data collection was done. Data gathered was analysed by using descriptive and inferential statistics. Based on the analysis interpretations were made.The study analysis shows that immediate breast feeding statistically reduces the duration of third stage of labor and the amount of blood loss.

Duration of the Third Stage of Labor and Estimated Blood Loss in Twin Vaginal Deliveries.

Objective The main aim of this study was to characterize the duration of the third stage of labor and estimated blood loss in twin vaginal deliveries. Study Design This was a retrospective case–control study. The data was collected from deliveries at the University of Arkansas for Medical Sciences in Little Rock, Arkansas, from January 2013 to June 2017. Women were identified who had twin gestation, were delivered vaginally, and whose maternal age was greater than 18 years old. Women were excluded if they had an intrauterine fetal demise, delivered either/both fetuses via cesarean, history of a previous cesarean or a fetus with a congenital anomaly. If a subject met criteria to be included in the study, the next normal singleton vaginal delivery was used as the control subject. Results There were 132 singleton vaginal deliveries and 133 twin vaginal deliveries analyzed. There was no significant difference in the length of the third stage of labor between twin and singleton vaginal deliveries except in the 95th percentile of the distribution. Mothers delivering twins had an increase in third-stage duration by 7.618 minutes (95% confidence interval [CI]: 0.73, 14.50; p = 0.03) compared with those who delivered singletons. The twin group had a higher estimated blood loss than singleton deliveries. The increase in blood loss in the twin group was 149.02 mL (95% CI: 100.2, 197.8), 257.01 mL (95% CI: 117.9, 396.1), and 381.53 mL (95% CI: 201.1, 562.1) at the 50th, 90th, and 95th percentiles, respectively. When the third stage of labor was at the 90th percentile or less in twin pregnancy (14 minutes), estimated blood loss was less than 1000 mL. Conclusion Twin pregnancy is a known risk factor for postpartum hemorrhage. As the duration of the third stage prolongs, the risk for hemorrhage also increases. We recommend delivery of the placenta in twin pregnancies by 15 minutes to reduce this risk. Key Points The third stage is longer in twin pregnancy at extremes.Twin placentas should be delivered by 15 minutes.Manually extract the placenta when third stage is prolonged.

Effectiveness of skin to skin contact between mother and baby at birth on maternal and neonatal outcomes among parturients

Third stage of labour is very crucial period in a women’s life. Previously uneventful first and second stage can become abnormal within a minute with disastrous consequences. In the third stage, the mothers face many problems like haemorrhage, retained placenta and inversion of the uterus. Early skin to skin contact at birth along with the breastfeeding process is protective against the incidence and severity of PPH. This study was conducted to determine the effectiveness of skin to skin contact between mother and baby at birth on maternal and neonatal outcomes among parturients.The objectives were to determine the effectiveness of skin to skin contact between mother and baby at birth on maternal outcomes among parturients and to determine the effectiveness of skin to skin contact between mother and baby at birth on neonatal outcomes among parturients. A quasi experimental research approach was used for the study. After obtaining permission from institutional ethical committee a total of 70 parturients admitted at labour room, Medical college hospital, Kottayam (35 each in control and experimental group) were selected for the study by purposive sampling technique. The data collection instruments were socio – personal and clinical data sheet, APGAR newborn scoring chart, observation checklist during third stage of labour, infant breastfeeding assessment tool (IBFAT), LATCH scale and modified maternal breastfeeding satisfaction evaluation scale (MBFES). Skin to skin contact between mother and baby at birth implemented in experimental group immediately after normal vaginal delivery for 30 minutes. Post-test for duration of third stage of labour, blood loss during third stage of labour, initiation of breast feeding, quality of first breast feeding and maternal satisfaction were performed within 80 minutes after normal vaginal delivery in control and experimental group. The data were tabulated and analyzed using descriptive and inferential statistics.The results of the study revealed that skin to skin contact between mother and baby at birth had statistically significant effect on maternal outcomes (duration of third stage of labour, blood loss during third stage of labour and maternal satisfaction) and neonatal outcomes (initiation of breastfeeding, quality of first breastfeeding and time of initiation of first breastfeeding) (p &amp;#60; 0.05).The result revealed that skin to skin contact between mother and baby at birth had effect on reducing duration of third stage of labour and blood loss during third stage of labour, improving maternal satisfaction, initiation of breastfeeding, quality of first breastfeeding and time of initiation of first breastfeeding.

Effect of placental cord blood drainage on duration of third stage of labour

Introduction: Third stage of labour start after delivery of baby and continues till delivery of placental and membranes. Post-partum hemorrhage is most common complication of this stage. &#x0D; Objectives: To compare the mean duration of third stage of labour in patients undergoing spontaneous vaginal delivery with and without placental cord blood drainage.&#x0D; Materials and Methods: This randomized control trial was carried out in three tertiary care hospitals of Punjab, Department of Obstetrics &amp;Gynecology, Allied Hospital, Faisalabad, Lady Aitcheson Hospital Lahore and Lady Willington Hospital Lahore. From 1st July 2018 to 30th December 2018, 188 cases (94 in each group) were selected using non probability consecutive sampling. Total 188 patients were enrolled in the study after taking informed consent and allocated into control and case group by lottery method. In control group cord was clamped from both sides while in case group cord was unclamped from other side and duration of third stage was noted for both groups. Ethical approval was taken from hospital ethical committee.&#x0D; Results: The mean age was 29.06 ± 4.9 years with minimum age of 21 years and maximum age of 45 years. More patients belong to younger age group (20 years to 35 years) i.e. 119 while 69 belonged to elder age group i.e. 36 year to 50 years 63.2 % and 36.7% respectively. Mean duration of third stage of labour in case group was 8.5±2.9 minutes and in control group 10.8±5.4 minutes. More distribution of patients in younger age group 20 -35 years and less in 36 to 50 years i.e. 67% and 33% respectively.&#x0D; Conclusion: This study concluded that unclamping placenta from mother side significantly reduces the third stage of labour

A double-blind placebo-controlled randomized trial on the effect of hyosine n-butyl bromide for improving duration of labor in term pregnancies.

To compare the effectiveness of intramuscular hyocine n-butyl bromide (HBB) with placebo for shortening the duration of the first stage of labor in term pregnancies. A double blind placebo-controlled randomized trial of parturients who presented at term in the active phase of labor was conducted. They were randomly (1:1 ratio) given intramuscular injection of either 40 mg (2 mL) of HBB or 2 mL of water for injection as a placebo. The primary outcome measures were the duration of first and second stages of labor. Subgroup analysis of primigravid and multigravid women were also performed for various outcomes. We did intention-to-treat analysis. Sixty-two women were randomized to each group and none were lost to follow-up. Baseline characteristics were similar between the HBB and placebo groups. The mean duration of first stage of labor was noted to be significantly shorter in the HBB group for both the primigravidas (246.6 ± 21.9 vs 391.8 ± 56.6 min for control; P < 0.001) and for multigravidas (205.9 ± 17.8 vs 323.8 ± 16.0 min for control;P < 0.001).There was also significantly shorter duration of second stage of labor in the HBB group (primigravida: P = 0.013; multigravida: P = 0.016). The duration of third stage of labor, mode of delivery and maternal and/or neonatal outcomes for both classes of parturients were not significantly different. HBB is effective in reducing the first and second stages of labor without adverse maternal or neonatal outcome. HBB does not significantly influence the duration of third stage of labor including mode of delivery. More evidence is needed to further explore the potential useful role of HBB in the active phase of labor.