Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
Integrated Maternal and Newborn Care Basic Skills Course ...
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APPENDIX C: Glossary<br />
Active management of the third stage of labor (AMTSL): A combination of actions<br />
performed during the third stage of labor to prevent PPH. AMTSL speeds delivery of the<br />
placenta by increasing uterine contractions <strong>and</strong> prevents PPH by minimizing uterine<br />
atony. The components of AMTSL are:<br />
• Administration of a uterotonic drug within one minute after the baby is born (oxytocin is<br />
the uterotonic of choice) after verifying that there is no second baby.<br />
• Controlled cord traction (CCT).<br />
• Uterine massage immediately after delivery of the placenta.<br />
Controlled cord traction (CCT): Traction on the cord during a contraction combined<br />
with countertraction upward on the uterus with the provider’s h<strong>and</strong> placed immediately<br />
above the symphysis pubis. CCT facilitates expulsion of the placenta once it has<br />
separated from the uterine wall.<br />
Delayed cord clamping: Clamping the umbilical cord after cord pulsations have<br />
ceased. Studies show that delaying clamping <strong>and</strong> cutting of the umbilical cord is helpful<br />
to both full-term <strong>and</strong> preterm babies. In situations where cord clamping <strong>and</strong> cutting was<br />
delayed for preterm babies, these infants had higher hematocrit <strong>and</strong> hemoglobin levels<br />
<strong>and</strong> a lesser need for transfusions in the first 4 to 6 weeks of life than preterm babies<br />
whose cords were clamped <strong>and</strong> cut immediately after birth.<br />
Delayed PPH: Excessive vaginal bleeding (vaginal bleeding increases rather than<br />
decreases after delivery), occurring more than 24 hours after childbirth.<br />
Immediate PPH: Vaginal bleeding in excess of 500 mL, occurring less than 24 hours<br />
after childbirth.<br />
Immediate postpartum period: See fourth stage of labor.<br />
Infant mortality rate: Number of deaths during the first year of life, expressed per 1000<br />
live births.<br />
Live birth: A baby who is born alive as indicated by the baby moving, crying, breathing, having<br />
heart beats, or showing cord pulsations.<br />
Low birth weight infant: A newborn weighing less than 2500 grams at birth. A low birth weight<br />
infant (LBW) may be preterm, with or without intrauterine growth retardation (IUGR), or full term,<br />
or post term with IUGR.<br />
Neonatal mortality rate: Number of newborn deaths during the first 28 days of life, expressed<br />
per 1000 live births.<br />
Neonatal period: This period commences at birth <strong>and</strong> ends at 28 completed days of life. The<br />
neonatal period is divided into two parts: the early neonatal period extends from day 1 to 7<br />
completed days; the late neonatal period extends from day 8 to 28 completed days.<br />
Perinatal mortality rate: The number of stillbirths <strong>and</strong> deaths in the first week of life, expressed<br />
per 1000 live plus stillbirths.<br />
Perinatal period: This period extends from the 22d week of gestation to the end of the first<br />
week of life (7 completed days). In some developing countries, authorities feel that since<br />
168<br />
<strong>Integrated</strong> maternal <strong>and</strong> newborn care<br />
<strong>Basic</strong> skills course