Re: [ozmidwifery] question

[Mary Murphy]

Hi Sue, As you know, active third stage is not my usual way of 3rd stage "management".  It would seem logical that if you are using IMI syntocinon, then you would need to wait until at least 2-4 minutes until the drug affects the uterus, then wait for a contraction and the fundus to become "lower" before putting any strong traction on the cord.  The usual signs of separation should be observed.  If you are using syntometrine I am not sure if the cervix closes over  and perhaps maks the bloody signs of separation.  I am interested in this one as some of the outer metro hospitals in Perth have gone back to using syntometrine instead of syntocinon.  I await the usual experienced  relies from  this vast network of midwives.  Maybe the student midwives have the textbook answer?  Cheers, MM When performing active management of the third stage, is it routine practice to await signs of placental separation before commencing CCT, or to simply ascertain that there is uterine contraction?   Also, what is the current recommendation for management of retained placenta, or situations when the cord separates during CCT?   I