A 25-year-old primigravida had an uncomplicated vaginal delivery 12 days ago. She now presents with fever (38.8°C), foul-smelling lochia, and uterine subinvolution. On examination, the uterus is tender. Which of the following statements about the third stage of labour is MOST directly related to preventing this complication?
- A Passive management reduces puerperal endometritis
- B Active management of the third stage reduces the risk of retained placental fragments ✓
- C Oxytocin administration after placental delivery reduces PPH risk by reducing uterine atony
- D Controlled cord traction prevents uterine inversion
Correct answer: B. Active management of the third stage reduces the risk of retained placental fragments
Explanation
Active management of the third stage of labour (AMTSL) includes a prophylactic uterotonic, controlled cord traction, and uterine massage. AMTSL significantly reduces the risk of retained placental fragments, which are a major cause of secondary PPH and puerperal endometritis. Retained products create a nidus for infection and prevent proper uterine involution. The correct management for this patient is uterine evacuation plus antibiotics.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.