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

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. From March 1999 to December 1999, the Global Network for Perinatal and Repr...

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Bibliographic Details
Published in:	Bulletin of the World Health Organization Vol. 81; no. 4; pp. 286 - 291
Main Authors:	FESTIN, Mario R, LUMBIGANON, Pisake, PEEDICAYIL, Abraham, PRAMONO, Noor, PURWAR, Manorama, SHENOY, Sheela, DALY, Sean, TOLOSA, Jorge E, FINNEY, Kathryn A, BA-THIKE, Katherine, CHIPATO, Tsungai, GAITAN, Hernando, LIANGZHI XU, LIMPONGSANURAK, Sompop, MITTAL, Suneeta
Format:	Journal Article
Language:	English
Published:	Genève Organisation mondiale de la santé 01-01-2003 World Health Organization The World Health Organization
Subjects:	Biological and medical sciences Childbirth & labor Cross-Sectional Studies Delivery Delivery, Obstetric - methods Delivery. Postpartum. Lactation Developed Countries Developing Countries Evaluation Evidence-Based Medicine Female Gynecology. Andrology. Obstetrics Health aspects Health Care Surveys Health Policy & Services Health Services Research Hormones Hospitals, University Humans Industrialized nations International aspects Intervention Labor (Obstetrics) Labor stage Labor Stage, Third - drug effects Labor, Complicated LDCs Maternal health services Maternal mortality Medical records Medical sciences Multicenter studies Obstetric/methods Obstetrical techniques Obstetrics Oxytocics Oxytocin - pharmacology Oxytocin - therapeutic use Physiology Postpartum Hemorrhage - drug therapy Practice Practice Patterns, Physicians Pregnancy Pregnant women Prevention Reproductive health Surveys Third/drug effects Tropical medicine Umbilical Cord Vagina Womens health Human Teaching hospital Professional practice Developing countries Female Delivery Method Labor Knowledge Obstetrics Comparative study Geographical variation Developed countries Hospitales universitarios Oxitocina Países en desarrollo Multicenter studies Cordón umbilical Parto obstétrico Estudios transversales Hemorragia posparto Evidence-based medicine Tercer periodo del trabajo de parto Oxytocine Cordon ombilical Labor stage Troisième période accouchement Third Médecine factuelle Hôpital universitaire Obstetric Pays en développement Etude multicentrique Oxytocin Países desarrollados Délivrance Etude section efficace Postpartum hemorrhage Hospitals, University Obstétrique Hémorragie post partum Medicina basada en evidencia Umbilical cord Cross-sectional studies Pays développé
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Summary:	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. 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. 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. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0042-9686 1564-0604
DOI:	10.1590/S0042-96862003000400010