Study of the Active Management of the Third Stage of Labor (AMTSL) in Four Maternity Hospitals in the Commune of Kara (Togo)
2021
Introduction: Active management of the third period of labor (AMTSL) significantly
prevents postpartum hemorrhage onset. Objective: To assess the practice
of AMTSL in four maternity in the commune of Kara (Kara University Hospital
Center, Kara Tomde Regional Hospital Center, SOS Kara Mother-Child Hospital, and Adabawere Peripheral
Care Unit). Method: This was a cross-sectional descriptive study over
four months, from January 28 to May 28, 2019. Two questionnaires were used for
data collection: an observation and evaluation grid AMTSL practice and a
questionnaire for providers. The grid was designed and adapted to the RPC
repository model for emergency obstetric and neonatal care in Africa 2018. The
data was processed using the Epi Info 7 software. Results: During the
study period, 528 parturients were identified and 30 providers surveyed. No
provider had received ongoing training in AMTSL. The practice of AMTSL was
systematic at each delivery. The practice was correct in 45.8%. Factors
associated with incorrect practice were relationship between caregiver-patient
(p = 0.0005), placental examination (p = 0.0003), postpartum monitoring (p =
0.0001). Conclusion and Suggestion: The practice of AMTSL is systematic,
but it was incorrect regardless of the provider’s qualification. Continuing
education on AMTSL is necessary to prevent postpartum hemorrhage.
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