What is not done in third stage of labour as pa of ‘Active management of third stage’ protocol ?
**Core Concept**
Active management of the third stage of labor (AMTSL) is a crucial protocol to prevent postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide. It involves a series of steps to ensure controlled delivery of the placenta, minimize blood loss, and promote uterine contraction.
**Why the Correct Answer is Right**
The AMTSL protocol includes administration of uterotonic agents, such as oxytocin or ergotamines, to stimulate uterine contractions and reduce bleeding. The administration of ergotamines is not part of the AMTSL protocol. Instead, oxytocin is the preferred uterotonic agent due to its efficacy and safety profile.
**Why Each Wrong Option is Incorrect**
* **Option A:** Administration of uterotonic agents is a crucial step in AMTSL, so this option is not correct.
* **Option B:** This option is correct, as the administration of ergotamines is not part of the AMTSL protocol.
* **Option D:** This option is incorrect as manual removal of placenta is a step in AMTSL, not something that is not done.
**Clinical Pearl / High-Yield Fact**
The key to successful AMTSL lies in timely administration of uterotonic agents, controlled delivery of the placenta, and proper uterine massage to promote contraction and minimize bleeding.
**Correct Answer: B. This option is correct, as the administration of ergotamines is not part of the AMTSL protocol.