Integrated Maternal and Newborn Care Basic Skills Course ...

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