A 24-year-old primigravida delivers vaginally after an uncomplicated labor. The third stage is managed with oxytocin 10 IU IM with delivery of the anterior shoulder, controlled cord traction, and uterine massage after placental delivery. This approach is described as active management of the third stage of labor. Which component of this strategy has been shown to MOST significantly reduce the incidence of postpartum hemorrhage?
- A Oxytocin 10 IU IM with delivery of anterior shoulder ✓
- B Controlled cord traction for placental delivery
- C Uterine massage after placental delivery
- D Early cord clamping within 30 seconds
Correct answer: A. Oxytocin 10 IU IM with delivery of anterior shoulder
Explanation
Prophylactic oxytocin with delivery of the anterior shoulder is the single most effective component of active management of the third stage, reducing PPH incidence by approximately 60 percent. Controlled cord traction and uterine massage are adjunctive. Early cord clamping is no longer recommended as it reduces neonatal iron stores without reducing PPH. The key intervention is timely uterotonic administration.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.