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Preventing Postpartum Hemorrhage through Active Management of the Third Stage of Labor

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Preventing Postpartum Hemorrhage through Active Management of the Third Stage of ... Oxytocin 10 IU IM or IV within one minute after birth of baby ... – PowerPoint PPT presentation

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Title: Preventing Postpartum Hemorrhage through Active Management of the Third Stage of Labor


1
Preventing Postpartum Hemorrhage through Active
Management of the Third Stage of Labor
  • or Life is But a Stage, and We Should All Be
    Actively Managing It

2
OBJECTIVES
  • Review the use of active management of the third
    stage of labor to prevent PPH
  • Examine new approaches for the prevention of PPH
  • Discuss program issues related to prevention of
    PPH

3
Presenters
  • Amanda Huber
  • PPH Program Manager
  • PRIME II/Intrah
  • University of North
  • Carolina, Chapel Hill
  • Patricia Gomez
  • Dir. of Midwifery Services
  • MNH Program
  • JHPIEGO-an affiliate of
  • Johns Hopkins University

4
130,000 women bleed to death
5
We Know That
  • Preventing PPH is the single most powerful way to
    decrease maternal mortality in most countries.
  • So what can we do to prevent it?

6
What is Active Management of Third Stage of
Labor (AMTSL)?
  • Oxytocin 10 IU IM or IV within one minute after
    birth of baby
  • Controlled cord traction with counter-traction to
    uterus
  • Fundal massage

7
Comparison of Active and Physiologic Management
8
Another Way to Prevent PPH?
  • PPH, mostly due to atonic uterus, remains major
    cause of maternal death
  • Emergency care often unavailable in homes and
    remote health facilities
  • Oxytocin requires cold chain and injection
  • Ergometrine contraindicated for women with high
    blood pressure

9
How Management Affects the Risk of PPH
10
Lessons Learned
  • Stakeholder partnership leadership by MOH and
    national professional societies is key, even if
    it is labor-intensive
  • Policy environment must allow midlevel
    providers to administer oxytocics
  • Drug supply security the earlier this is
    addressed, the better

11
Dénouement
  • Our goal is that AMTSL, with high-quality
    oxytocics, is performed for every normal birth
    that is attended by a skilled provider.

12
End of soliloquies…
  • Time for dialogue!
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