International survey on variations in practice of the management of the third stage of labour

Mario R. Festin, Pisake Lumbiganon, Jorge E. Tolosa, Kathryn A. Finney, Katherine Ba-Thike, Tsungai Chipato, Hernando Gaitán, Liangzhi Xu, Sompop Limpongsanurak, Suneeta Mittal, Abraham Peedicayil, Noor Pramono, Manorama Purwar, Sheela Shenoy, Sean Dalyl

Research output: Contribution to journalArticle

61 Scopus citations

Abstract

Objective: To determine the use of the active management of the third stage of labour in 15 university-based obstetric centres in ten developing and developed countries and to determine whether evidence-based practices were being used. Methods: From March 1999 to December 1999, the Global Network for Perinatal and Reproductive Health (GNPRH) conducted an observational, cross-sectional survey to assess the use of the practice and its components. Prospective data on patient characteristics and the interventions used in the management of the third stage of labour were collected using standardized methods. Data on approximately 30 consecutive vaginal deliveries in each centre (452 in total) were included. Findings: Significant intracountry and intercountry variation in the practice of the active management of the third stage of labour was found (111/452 deliveries used active management), which confirmed the existence of a large gap between knowledge and practice. Conclusion: Areas identified for improvement are the urgent implementation of the evidence-based clinical management practice defined as the active management of the third stage of labour; increased accessibility to systematic reviews in developing countries; and the conduction of clinical trials that assess the impact of this intervention in other settings.

Original languageEnglish (US)
Pages (from-to)286-291
Number of pages6
JournalBulletin of the World Health Organization
Volume81
Issue number4
StatePublished - May 17 2003

Keywords

  • Cross-sectional studies
  • Delivery, Obstetric/methods
  • Developed countries
  • Evidence-based medicine
  • Hospitals, University
  • Labor stage Third/drug effects
  • Multicenter studies
  • Oxytocin/therapeutic use
  • Postpartum hemorrhage/drug therapy
  • Umbilical cord

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Festin, M. R., Lumbiganon, P., Tolosa, J. E., Finney, K. A., Ba-Thike, K., Chipato, T., Gaitán, H., Xu, L., Limpongsanurak, S., Mittal, S., Peedicayil, A., Pramono, N., Purwar, M., Shenoy, S., & Dalyl, S. (2003). International survey on variations in practice of the management of the third stage of labour. Bulletin of the World Health Organization, 81(4), 286-291.