In active management of the third stage of labor, the component MOST responsible for reducing postpartum hemorrhage compared to physiological management is:

• A Uterotonic administration (oxytocin) immediately after delivery ✓
• B Early cord clamping
• C Controlled cord traction (Brandt-Andrews maneuver)
• D Uterine massage after placental delivery

Explanation

Active management of the third stage of labor (AMTSL) comprises three components: uterotonic drug after delivery, controlled cord traction, and uterine tone assessment. Multiple RCTs have shown that oxytocin administration is the single most effective component — accounting for the majority of PPH reduction benefit. Studies removing controlled cord traction (e.g., the TRACOR trial) found no significant increase in PPH when oxytocin was still given. Uterine massage after placental delivery is no longer universally recommended as it adds no significant benefit when oxytocin is used.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.