الفهرس 
Third Stage of LabourOnly 14 pages are availabe for public view
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Abstract
The third stage is the interval between delivery of the infant and delivery of the placenta. This stage averages 10 minutes and is considered prolonged if it lasts longer than 30 minutes, placental separation occurs as a result of continued uterine contractions, continued contractions control blood loss by compression of spiral arteries and also result in migration of the placenta into the lower uterine segment and then through the cervix.
The purpose of this study is to evaluate the effect of intraumbilical vein injection of oxytocin on reducing the duration of the third stage of labor and the need for manual delivery of placenta, ,in addition to reduce blood loss during third and fourth stage of labor and decrease incidence of retained placenta in comparison with inraumbilical injection of normal saline.
This is a prospective randomized control trial conducted at Ain Shams University Maternity Hospital. This study included 240 term pregnant women in labor admitted to the labor ward, They were divided into two groups:
group (A): The experimental group, 10 units of oxytocin will be injected into the umbilical vein at the most proximal site to the placenta after clamping and cutting of the umbilical cord.
group (B): The control group, 1 mL normal saline will be injected into the umbilical vein at the most proximal site to the placenta after clamping and cutting of the umbilical cord.
The third stage of labor will be actively managed in the two groups by infusion of 20 IU oxytocin in 1 L Ringer’s lactate solution at a rate of 100 ml/min, immediately after delivery of the fetus.
The two groups will be compared in the following terms:
1) The duration of the third stage of labor by stopwatch.
2) Hemoglobin (Hb) difference before and 12 h after delivery.
3) The need for manual delivery of the placenta.
Manual removal of the placenta will be commonly carried out under general sedation in the operating room, if the placenta will not be delivered 30 min after fetal delivery.
4) Estimate blood loss by Allowable Blood Loss (ABL) (Miller, 2000).
EBV x (Hi - Hf)
Hi = ABL
Hi = initial Hct
Hf = final lowest acceptable Hct
Estimated Blood Volume (EBV) = weight (kg) x average blood volume (70 mL/kg)
Results:
There was no statistically significant difference between the two groups concerning age, parity and gestational age.
Comparison between both study and placebo groups regarding amount of blood loss, need of placental separation and the duration of the third and fourth stages of labor showed that There were high statistically significant differences between both groups, with less amount of blood loss, less need for manual placental separation and shorter duration of the third stage of labor among study group.