Objective: Use of ultrasound imaging to characterize the patterns of placental separation during active management of the third stage of labour(AMTSL) to explain the effect of different components on the mechanism of placental separation.
Methods: 150 women admitted in labour who are nulliparous, gestational age from 37 to 40 weeks,singleton pregnancy,cephalic presentation and delivered vaginally will be randomized into three groups for management of the third stage;
50 women will be managed with full package of the active management of the third stage [10 IU of oxytocin are given IM after delivery of the baby, delayed cord clamping and controlled cord traction will be done when the uterus contracted].
50 women will be managed using a simplified package(uterotonic after delivery of the baby, delayed cord clamping, no controlled cord traction)
50 women will be managed physiologically(no uterotonic, no controlled cord traction)
Continuous real time ultrasonographic examination will be done ….
Results: This an ongoing study .The outcomes of the study will be:………