Question:
Two related recalls on active management of the third stage of labour. (a) Which of the following interventions is not recommended in active management of the third stage of labour? A. Administration of uterotonic within 1 minute of delivery, B. Immediate clamping, cutting and ligation of cord, C. Gentle massage of uterus, D. Controlled cord traction (Ans B). (b) Active management of the third stage of labour includes all of the following except: A. Oxytocin injection, B. Ergometrine injection, C. Controlled cord traction, D. Gentle massage of uterus. The combined answer below addresses part (a). Which intervention is not recommended in active management of the third stage?
Two related recalls on active management of the third stage of labour. (a) Which of the following interventions is not recommended in active management of the third stage of labour? A. Administration of uterotonic within 1 minute of delivery, B. Immediate clamping, cutting and ligation of cord, C. Gentle massage of uterus, D. Controlled cord traction (Ans B). (b) Active management of the third stage of labour includes all of the following except: A. Oxytocin injection, B. Ergometrine injection, C. Controlled cord traction, D. Gentle massage of uterus. The combined answer below addresses part (a). Which intervention is not recommended in active management of the third stage?
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Modern AMTSL favours delayed, not immediate, cord clamping.
Updated On: Jun 24, 2026
- Administration of uterotonic within 1 minute of delivery
- Immediate clamping, cutting and ligation of cord
- Gentle massage of uterus
- Controlled cord traction
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The Correct Option is B
Solution and Explanation
Step 1: Active management of the third stage of labour (AMTSL) is the package used to reduce postpartum haemorrhage. Its core components are a uterotonic, controlled cord traction, and uterine assessment/massage.
Step 2: A uterotonic (oxytocin) given soon after delivery of the baby is a key, recommended step. So option A is recommended, not the answer.
Step 3: Controlled cord traction with counter-pressure on the uterus helps deliver the placenta and is part of AMTSL. Option D is recommended.
Step 4: Gentle uterine massage after the placenta is delivered keeps the uterus contracted and reduces bleeding, so option C is recommended.
Step 5: Immediate cord clamping is NOT recommended. WHO advises delayed cord clamping (after 1 to 3 minutes) for better neonatal iron stores; early routine clamping is no longer part of good AMTSL. So option B is the intervention not recommended and is the answer for part (a).
For part (b), where the choices are oxytocin, ergometrine, controlled cord traction, and uterine massage, the formal AMTSL components are the uterotonic, controlled cord traction and massage, so ergometrine as a separate routine injection is the relative exception there.
The answer to part (a) is immediate clamping and ligation of cord, option B.
Step 2: A uterotonic (oxytocin) given soon after delivery of the baby is a key, recommended step. So option A is recommended, not the answer.
Step 3: Controlled cord traction with counter-pressure on the uterus helps deliver the placenta and is part of AMTSL. Option D is recommended.
Step 4: Gentle uterine massage after the placenta is delivered keeps the uterus contracted and reduces bleeding, so option C is recommended.
Step 5: Immediate cord clamping is NOT recommended. WHO advises delayed cord clamping (after 1 to 3 minutes) for better neonatal iron stores; early routine clamping is no longer part of good AMTSL. So option B is the intervention not recommended and is the answer for part (a).
For part (b), where the choices are oxytocin, ergometrine, controlled cord traction, and uterine massage, the formal AMTSL components are the uterotonic, controlled cord traction and massage, so ergometrine as a separate routine injection is the relative exception there.
The answer to part (a) is immediate clamping and ligation of cord, option B.
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