WHO recommendations for prevention of PPH by active management of third stage of labour Components of Active Management of the Third Stage of Labour (WHO)Administration of uterotonic soon after bih of baby.Delayed cord clamping and cutting.Controlled cord traction for delivery of the placenta (Brandt Andrew&;sMethod).Uterine massage.Uterotonic Agents Used in AMTSLInjectable oxytocin is the first line agent as it is effective after 2-3 minutes and has minimal side effects. Recommended dose by WHO is 10 units IM.Injectable methylergometrine (methergine) 0.2 mg IM/IV delivery of anterior shoulder or immediately after DELIVERY OF BABY.Syntometrine or Oxymatrine (ERGOMETRINE 0.5 MG +OXYTOCIN 5 UNITS) IM after delivery of the baby.Misoprostol 600 microgram tablet orally or rectally (in home delivery). Oral administration of misoprostol should be reversed for situations when the safe administration and/or appropriate storageconditions for injectable oxytocin and ergot alkaloids are not possible.Cord ClampingEarly cord clamping which was included originally in AMTSL not recommended now.Delayed cord clamping is now recommended and not immediate cord clamping.Current evidence shows that delayed cord clamping is beneficial for the baby.Immediate cord clamping has been shown to increase the incidence of iron deficiency and anemia.For premature and low bih weight babies immediate cord clamping can also increase the risk of intraventricular hemorrhage and late-onset sepsis.Controlled Cord TractionRecommended intervention for delivery of the placenta and a well-documented intervention in the active management of third stage of labour.(Refer: Mudaliar and Menon&;s Clinical Obstetrics, 11th edition, pg no: 121)