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Active management of the third stage of labor (AMTSL) describes interventions with the common goal to prevent postpartum hemorrhage (PPH). A systematic search was conducted in five databases in September 2015 to identify intervention studies of AMTSL implemented by unskilled birth attendants or pregnant women themselves. Task shifting of AMTSL has thus far been evaluated for administration of uterotonics (misoprostol tablets and oxytocin injected by CHWs and auxiliary midwives) and resulted in reduction of PPH, high rates of appropriate use and satisfaction among users.
References
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Sibley LM, Spangler SA, Barry D, Tesfaye S, Desta BF, Gobezayehu AG. A regional comparison of distribution strategies and women’s awareness, receipt, and use of misoprostol to prevent postpartum hemorrhage in rural Amhara and Oromiya regions of Ethiopia. J Midwifery Womens Health. 2014;59(Suppl 1):S73–82.
Gülmezoglu AM, Lumbiganon P, Landoulsi S, Widmer M, Abdel-aleem H, Festin M, et al. Active management of the third stage of labour with and without controlled cord traction : a randomised, controlled, non-inferiority trial. Lancet Elsevier Ltd. 2007;379:1721–7.