Active management of the third stage of labor reduces the incidence of postpartum hemorrhage by approximately two-thirds. Which single component of this package contributes most to the reduction?

• A Early cord clamping within one minute
• B Immediate fundal pressure massage after delivery
• C Controlled cord traction with Brandt-Andrews maneuver
• D Prophylactic oxytocin 10 IU intramuscularly after delivery of the baby ✓

Explanation

Prophylactic uterotonic administration, classically oxytocin 10 IU IM after the anterior shoulder or immediately after birth, is the component responsible for most of the benefit, reducing PPH by roughly half on its own. Controlled cord traction adds a small further reduction, early cord clamping contributes little and is now discouraged because of neonatal iron stores, and fundal pressure is not part of recommended practice and risks inversion.

Reference: WHO Recommendations on Maternal and Newborn Care, 2018 guideline ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.