Pharmacologic management of the third stage of labor
- Eran Bornstein, MD
Eran Bornstein, MD
- Assistant Professor
- Maternal Fetal Medicine
- Director of Obstetrics
- Lenox Hill Hospital
The third stage of labor refers to the interval from delivery of the baby to separation and expulsion of the placenta. The major complications of the third stage of labor are:
●Hemorrhage (see "Overview of postpartum hemorrhage" and "Management of postpartum hemorrhage at vaginal delivery")
●Retained placenta (see "Retained placenta after vaginal birth")
●Uterine inversion (see "Puerperal uterine inversion")
This topic will discuss use of drugs to minimize blood loss and prevent postpartum hemorrhage. Other aspects of management of the third stage, such as the procedure for delivery of the placenta, are reviewed separately. (See "Management of normal labor and delivery", section on 'Management of the third stage of labor'.)
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- ACTIVE MANAGEMENT
- PHARMACOLOGIC THERAPIES
- Our approach
- - Timing
- - Route and dose
- Intravenous infusion
- Intramuscular administration
- Intravenous bolus
- Injection into an umbilical vein
- Ergot alkaloids
- - Ergometrine-oxytocin
- Oxytocin agonists
- Tranexamic acid
- SELECTED SPECIFIC SETTINGS
- Poor medical resource settings
- Cesarean delivery
- SUMMARY AND RECOMMENDATIONS