The components of active management of third stage of labour includes all except

NHM UP Staff Nurse-2021 Shift-2nd

Obstetrics & Gynaecology

Easy

Appeared in: NHM UP Staff Nurse-2021 Shift-2nd

Explanation

Rooming-in is a postpartum care practice where the newborn baby is kept in the same room as the mother, rather than in a separate nursery.
The primary goals of rooming-in are to promote mother-infant bonding, facilitate early and exclusive breastfeeding, and help the mother gain confidence in caring for her baby.
This practice takes place during the postpartum period (fourth stage of labor and beyond), which begins after the delivery of the placenta.
It is not an intervention used to manage the third stage of labor or to prevent the immediate complication of postpartum hemorrhage.

Option A: This is incorrect because the administration of a uterotonic drug, with oxytocin being the agent of choice, is a cornerstone of AMTSL. It is given within one minute of the baby's birth to induce strong uterine contractions.
Option B: This is incorrect because uterine massage is a key step in AMTSL. It is performed immediately after the placenta is delivered to ensure the uterus remains firm and contracted, thereby preventing uterine atony and excessive bleeding.
Option C: This is incorrect because facilitating the delivery of the placenta is the primary goal of the third stage of labor. In AMTSL, this is achieved through Controlled Cord Traction (CCT) once signs of placental separation are evident.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Active Management of Third Stage of Labor (AMTSL) as background academic context rather than a clinical decision trigger.
AMTSL is a critical, evidence-based intervention proven to significantly reduce the incidence of postpartum hemorrhage (PPH), a leading cause of maternal mortality worldwide.
Nurses play a vital role in ensuring all components of AMTSL are performed correctly and in a timely manner, including administering medication, assisting with placental delivery, and assessing uterine tone.
Recognizing the difference between third stage management and postpartum care is essential for providing appropriate and timely interventions to ensure the safety of both mother and baby.

How to Approach the Question

First, identify that the question uses the keyword 'except'. This means you are looking for the option that is NOT a component of the active management of the third stage of labor (AMTSL).
Next, recall the definition and purpose of the third stage of labor, which is the period from the birth of the baby until the placenta is delivered.
Then, list the key interventions included in AMTSL. The primary components are: administration of a uterotonic drug (like oxytocin), controlled cord traction to deliver the placenta, and uterine massage after placental delivery.
Evaluate each option against your knowledge of AMTSL.
Option A (Use of oxytocin), Option B (Uterine massage), and Option C (Delivery of placenta) are all integral parts of AMTSL.
Option D (Rooming in) is a practice related to mother-baby care in the postpartum period, which occurs after the third stage of labor is complete. Therefore, it is the correct exception.

Concept Tested & Keywords

Concept Tested: Active Management of Third Stage of Labor (AMTSL)
Stem keywords: active management, third stage of labour, components
Lead-in keywords: all except
Negative lead-in flag: The question uses negative framing ('EXCEPT'), asking you to identify the option that does NOT belong. This requires you to know all the components of AMTSL to spot the outlier.

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E6 Comprehensive Textbook of Community Health Nursing for BSc Nursing Students Part 2 — Subpart A (pp 1-275 of 550) p. 222-224

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