Active management of third stage of labour; a survey of providers’ knowledge in southwest Nigeria
Date
2009
Authors
Oladapo, O.T
Fawole, A.O
Loto, O.M
ADEGBOLA, O
Akinola, O.I
Alao, M.O
Adeyemi, A.S
Journal Title
Journal ISSN
Volume Title
Publisher
Springer-Verlag
Abstract
Background The disparity between current evidence and
practice on active management of third stage of labour
(AMTSL) demands assessment of providers’ knowledge on
the subject.
Objective To assess the level and determinant(s) of accurate
knowledge of obstetric providers regarding AMTSL.
Methods Questionnaire-based survey of 361 labour and
delivery professionals in public tertiary obstetric centres in
southwest Nigeria.
Results Female nurses at diVerent cadres accounted for
most of the respondents. Majority (90.6%) of the respondents
reported being aware of AMTSL as an obstetric
intervention and 49.7% were aware of FIGO/ICM recommendation
on AMTSL. Out of 13 potential third
stage interventions, 102 respondents (28.3%) correctly
and exclusively identiWed the components of AMTSL as
deWned by FIGO/ICM. Many procedures reserved for
treatment of complicated third stage of labour such as
manual placental removal (37.7%), blood transfusion
(20.2%), bimanual uterine compression (24.7%) and
uterine artery ligation (13.9%) were also selected as
AMTSL components. Multivariate logistic regression
analysis indicated that being in administrative position
(adjusted OR: 2.68; CI 1.19–6.02) and frequent compared
to rare or no consultation of books, journal and
internet sources for information (adjusted OR: 2.58; CI
1.21–5.52) increased the odds of having accurate
knowledge of AMTSL while being a nurse/midwife
(adjusted OR: 0.15; CI 0.05–0.39), matron (adjusted OR:
0.25; CI 0.08–0.79) or intern (adjusted OR: 0.07; CI
0.01–0.29) compared to postgraduate resident doctors
reduced the odds of having accurate knowledge of
AMTSL.
Conclusion AMTSL was a familiar but poorly understood
intervention among obstetric care providers in this region.
Improvement in healthcare quality and practitioners’ adherence
to recommended guidelines on AMTSL urgently
requires educational interventions that target those who
provide routine delivery care and organisation of the health
care delivery system in such a way that enables providers to
act on acquired knowledge
Description
Keywords
Postpartum haemorrhage · Active management · Third stage · Obstetric providers