Login Register Cart 0
Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Factors Associated with the Length of the Third Stage of Labour: A Descriptive-Analytical Study

Author(s): Mansoureh Refaei, Soodabeh Aghababaei, Mansoureh Yazdkhasti, Farideh Kazemi* and Fatemeh Farahmandpour

Volume 18, Issue 2, 2022

Published on: 06 April, 2021

Article ID: e241221192712 Pages: 8

DOI: 10.2174/1573404817666210406154510

Price: $65

Abstract

Background: Several risk factors have been identified for postpartum hemorrhage, one of which being the duration of the third stage of labour. This stage refers to the interval between the expulsion of the fetus to the expulsion of the placenta. Some bleeding occurs in this stage due to the separation of the placenta.

Objective: This study aimed to identify the factors associated with the length of the third stage of labour.

Methods: In this cross-sectional study, 300 women hospitalized for vaginal birth were selected via convenience sampling. The study data were collected using a researcher-made questionnaire. The data were then analyzed using univariate and multivariate linear regression analyses.

Results: The mean (SD) age of the participants was 26.41 (6.26) years. Investigation of the relationship between the study variables and the time of placental separation indicated that a minute increase in the length of membrane ruptures caused a 0.003 minute decrease in the time of placental separation. However, this time increased by 2.75, 6.68, and 2.86 minutes in the individuals without history of abortion, those with history of stillbirth, and those who had not received hyoscine, respectively. The results of multivariate analysis indicated that suffering from preeclampsia or hypertension, history of stillbirth, not receiving hyoscine, and not receiving misoprostol increased the length of the third stage by 4.40, 8.55, 2.38, and 6.04 minutes, respectively.

Conclusion: Suffering from preeclampsia and having the history of stillbirth increased and using hyoscine and misoprostol decreased the length of the third stage of labour. However, no significant relationship was found between the length of the third stage of labour and mother’s age, gestational age, parity, mother’s body mass index, mother’s chronic disorders, history of manual placenta removal, length of the first and second stages, membranes rupture, induction, amount of oxytocin after delivery, and infant’s weight and gender.

Keywords: Labour stage, third stage, length, placenta, postpartum hemorrhage, parturition.

Graphical Abstract

[1]
Begley CM, Gyte GM, Devane D, McGuire W, Weeks A. Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev 2011; (11): CD007412.
[http://dx.doi.org/10.1002/14651858.CD007412.pub3] [PMID: 22071837]
[2]
Ononge S, Mirembe F, Wandabwa J, Campbell OM. Incidence and risk factors for postpartum hemorrhage in Uganda. Reprod Health 2016; 13(1): 38.
[http://dx.doi.org/10.1186/s12978-016-0154-8] [PMID: 27080710]
[3]
Nyfløt LT, Sandven I, Stray-Pedersen B, et al. Risk factors for severe postpartum hemorrhage: a case-control study. BMC Pregnancy Childbirth 2017; 17(1): 17.
[http://dx.doi.org/10.1186/s12884-016-1217-0] [PMID: 28068990]
[4]
Magann EF, Doherty DA, Briery CM, Niederhauser A, Chauhan SP, Morrison JC. Obstetric characteristics for a prolonged third stage of labor and risk for postpartum hemorrhage. Gynecol Obstet Invest 2008; 65(3): 201-5.
[http://dx.doi.org/10.1159/000112227] [PMID: 18073485]
[5]
Hofmeyr GJ, Mshweshwe NT, Gülmezoglu AM. Controlled cord traction for the third stage of labour. Cochrane Database Syst Rev 2015; 1: CD008020.
[http://dx.doi.org/10.1002/14651858.CD008020.pub2] [PMID: 25631379]
[6]
Magann EF, Evans S, Chauhan SP, Lanneau G, Fisk AD, Morrison JC. The length of the third stage of labor and the risk of postpartum hemorrhage. Obstet Gynecol 2005; 105(2): 290-3.
[http://dx.doi.org/10.1097/01.AOG.0000151993.83276.70] [PMID: 15684154]
[7]
Frolova AI, Stout MJ, Tuuli MG, López JD, Macones GA, Cahill AG. Duration of the third stage of labor and risk of postpartum hemorrhage. Obstet Gynecol 2016; 127(5): 951-6.
[http://dx.doi.org/10.1097/AOG.0000000000001399] [PMID: 27054942]
[8]
Magann EF, Lutgendorf MA, Keiser SD, et al. Risk factors for a prolonged third stage of labor and postpartum hemorrhage. South Med J 2013; 106(2): 131-5.
[http://dx.doi.org/10.1097/SMJ.0b013e3182824d1e] [PMID: 23380748]
[9]
Shinar S, Shenhav M, Maslovitz S, Many A. Distribution of third-stage length and risk factors for its prolongation. Am J Perinatol 2016; 33(10): 1023-8.
[http://dx.doi.org/10.1055/s-0036-1572426] [PMID: 27135956]
[10]
Taebi M, Kalahroudi MA, Sadat Z, Saberi F. The duration of the third stage of labor and related factors. Iran J Nurs Midwifery Res 2012; 17(2)(Suppl. 1): S76-9.
[PMID: 23833605]
[11]
Shinar S, Anteby M, Many A. Short and long term complications of retained placenta after vaginal delivery. Am J Obstet Gynecol 2017; 216(1): S416.
[http://dx.doi.org/10.1016/j.ajog.2016.11.445]
[12]
von Schmidt auf Altenstadt JF, Hukkelhoven CW, van Roosmalen J, Bloemenkamp KW. Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands. PLoS One 2013; 8(12): e81959.
[http://dx.doi.org/10.1371/journal.pone.0081959] [PMID: 24367496]
[13]
Endler M, Saltvedt S, Cnattingius S, Stephansson O, Wikström AK. Retained placenta is associated with pre-eclampsia, stillbirth, giving birth to a small-for-gestational-age infant, and spontaneous preterm birth: a national register-based study. BJOG 2014; 121(12): 1462-70.
[http://dx.doi.org/10.1111/1471-0528.12752] [PMID: 24703089]
[14]
Rotem R, Pariente G, Golevski M, Baumfeld Y, Yohay D, Weintraub AY. Association between hypertensive disorders of pregnancy and third stage of labor placental complications. Pregnancy Hypertens 2018; 13: 166-70.
[http://dx.doi.org/10.1016/j.preghy.2018.06.004] [PMID: 30177047]
[15]
Rotem R, Lipski A, Weintraub AY, et al. Third stage of labor placental complications and placenta-associated syndromes. J Matern Fetal Neonatal Med 2019; 1-5.
[http://dx.doi.org/10.1080/14767058.2019.1684468] [PMID: 31711332]
[16]
Mortazavi F, Rakhshani M. Influence of atropine, hyoscine and promethazine on stages length and rate of labor progress in multiparous women. Gorgan med j 2005; 6(14): 92-6.
[17]
Pahlavani-Sheikhi Z, Razavi M. Hyoscine-N-butylbromide effect on the acceleration of labor and postpartum hemorrhage in primigravida women. Feyz 2017; 21(3): 218-23.
[18]
Enakpene CA, Morhason-Bello IO, Enakpene EO, Arowojolu AO, Omigbodun AO. Oral misoprostol for the prevention of primary post-partum hemorrhage during third stage of labor. J Obstet Gynaecol Res 2007; 33(6): 810-7.
[http://dx.doi.org/10.1111/j.1447-0756.2007.00661.x] [PMID: 18001447]
[19]
Lotfali zadeh M, Ghomian N. Comparison of the effect of oral misoprostol tablet with intravenous oxytocin for pregnancy termination in gynecology wards of academic Hospitals in Mashhad. Iran J Obstet Gynecol Infertil 2004; 9(2): 104-9.
[20]
Cummings KF, Helmich MS, Ounpraseuth ST, Dajani NK, Magann EF. The third stage of labour in the extremely obese parturient. J Obstet Gynaecol Can 2018; 40(9): 1148-53.
[http://dx.doi.org/10.1016/j.jogc.2017.12.008] [PMID: 30007800]
[21]
Feng J, Liu J, Bao A, et al. Effects of delayed umbilical cord clamping on maternal and neonatal outcomes. Chin Nurs Res 2018; 53(2): 144-8.
[22]
Jombo SE. Effects of delayed umbilical cord clamping on maternal and neonatal outcomes in IRRUA: a randomized controlled (open label) trial. PhD Dissertation. National Postgraduate Medical College of Nigeria 2017. Available from: https://www.dissertation.npmcn.edu.ng/index.php/FMCOG/article/view/1834
[23]
Qian Y, Ying X, Wang P, Lu Z, Hua Y. Early versus delayed umbilical cord clamping on maternal and neonatal outcomes. Arch Gynecol Obstet 2019; 300(3): 531-43.
[http://dx.doi.org/10.1007/s00404-019-05215-8] [PMID: 31203386]

Rights & Permissions Print Cite
Article Metrics
15
1
© 2024 Bentham Science Publishers | Privacy Policy