Which is not Included in active management of III stage of Labour?
**Core Concept**
Active management of the third stage of labor (AMTSL) involves a series of interventions aimed at preventing postpartum hemorrhage (PPH) and ensuring a safe delivery of the placenta. It is a critical component of postpartum care, particularly in settings with limited resources.
**Why the Correct Answer is Right**
The correct answer is the option that does not belong in the active management of the third stage of labor. The AMTSL protocol typically includes administering uterotonic agents, such as oxytocin or ergometrine, to induce uterine contractions and prevent bleeding. It also involves controlled cord traction (CCT) to facilitate the delivery of the placenta. The correct order of steps in AMTSL is:
- Administering uterotonic agents
- Controlled cord traction
- Uterine massage
- Delivery of the placenta
**Why Each Wrong Option is Incorrect**
**Option A:** Administering uterotonic agents is a crucial step in AMTSL, as it helps to induce uterine contractions and prevent bleeding.
**Option B:** Uterine massage is also an essential component of AMTSL, as it helps to stimulate uterine contractions and facilitate the delivery of the placenta.
**Option C:** Controlled cord traction (CCT) is a key step in AMTSL, as it helps to deliver the placenta safely and prevent PPH.
**Clinical Pearl / High-Yield Fact**
One key point to remember when performing AMTSL is to administer uterotonic agents immediately after delivery of the baby, and before the placenta is delivered. This helps to prevent PPH by inducing uterine contractions.
**Correct Answer:** D.