Third stage management: how important is it?

The normal physiology of the third stage of labour and the effect of oxytocics at the end of the second stage have been discussed. An assessment of the results of different policies of third stage management has been made, including a comparison of the advantages and disadvantages of the traditional method versus the use of controlled cord traction. It is recommended that ergometrine (0.25 mg) be administered intravenously after delivery of the baby, and the exclusion of a second twin. Once the uterus has contracted the placenta should then be delivered by the technique of controlled cord traction.