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Gynaecology & Obstetrics General obstetrics 351b1fc3

Which of the following is not included in the active management of third stage of labor to prevent postpaum haemorrhage (PPH)?

A
Uterotonic within 1 minute of delivery
B
Delayed clamping, cutting and ligation of cord
C
Gentle massage of uterus
D
Controlled cord traction
High-Yield Explanation
Uterine massage is not a cure component of Active management of Third stage of Labor (AMTSL) AMTSL recommended by WHO is a triad including: Immediate administration of prophylactic uterotonic (Oxytocin) Controlled cord traction during placental delivery Delayed cord clamping The goal of this triad is to prevent postpaum haemorrhage (PPH). Hence, uterotonics are the most impoant factor to decrease PPH. Delayed cord clamping is a less impoant component in this direction and similarly cord traction is not as critical. Uterine massage doesnot form the main component of AMTSL yet may be recommended by some and to be considered with the warning that evidence for this practice is not strong. Ref: Williams Obstetrics 24th edition Pgno: 547

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