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Turk J Obstet Gynecol. 2018 Sep;15(3):188-192. doi: 10.4274/tjod.39049. Epub 2018 Sep 3.

Active management of the third stage of labor: A brief overview of key issues.

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Muğla Sıtkı Koçman University, Training and Research Hospital, Clinic of Gynecology and Oncology, Muğla, Turkey.
Bilim University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey.
Kaman State Hospital, Clinic of Obstetrics and Gynecology, Kırşehir, Turkey.
University of Health Sciences, İzmir Tepecik Training and Research Hospital, Department of Obstetrics and Gynecology, İzmir, Turkey.


Postpartum hemorrhage is a potentially life-threatening, albeit preventable, condition that persists as a leading cause of maternal death. It occurs mostly during the third stage of labor, and active management of the third stage of labor (AMTSL) can prevent its occurrence. AMTSL is a recommended series of steps, including the provision of uterotonic drugs immediately upon fetal delivery, controlled cord traction, and massage of the uterine fundus, as developed by the World Health Organization. Here, we present current opinion and protocols for AMTSL.


Postpartum hemorrhage; active management of the third stage of labor; uterotonic agents

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Conflict of Interest: No conflict of interest was declared by the authors.

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