Terms

Definitions used in this review

Expectant management of third stage of labour

1. A prophylactic uterotonic agent is not administered;
2. the umbilical cord is neither clamped nor cut until the placenta has been delivered or until cord pulsation has ceased; and
3. the placenta is delivered spontaneously with the aid of gravity and sometimes by maternal effort.

Active management of third stage of labour

1. The routine administration of a prophylactic uterotonic drug just before, with, or immediately after, the birth of the baby;
2. early cord clamping and cutting; and
3. controlled cord traction to deliver the placenta.

Mixed management of third stage of labour

A mixture of some of the components of both active and expectant management of third stage, but without exclusively containing all the components of either. There can be a number of different mixed third stage managements, for example:
1. early prophylactic uterotonic drug, cord clamping when pulsation has ceased and controlled cord traction;
2. delayed prophylactic uterotonic drug, cord clamping when pulsation has ceased and controlled cord traction.

Early prophylactic uterotonic

Prophylactic uterotonic drug administered just before, with, or immediately after, the birth of the infant.

Delayed prophylactic uterotonic

Prophylactic uterotonic drug administered after the cord pulsation has ceased.

Early cord claming

The application of a clamp to the umbilical cord within 60 seconds of the birth of the infant (McDonald 2008).

Delayed cord clamping

The application of a clamp to the umbilical cord greater than one minute after birth or when cord pulsation has ceased (McDonald 2008).

Sarnat staging for hypoxic ischaemic encephalopathy (Sarnat 1976)

Stage 1 (mild): hyperalertness, hyper‐reflexia, dilated pupils, tachycardia, absence of seizures.

Stage 2 (moderate): lethargy, hyper‐reflexia, miosis, bradycardia, seizures, hypotonia with weak suck and Moro reflexes.

Stage 3 (severe): stupor, flaccidity, small to midposition pupils which react poorly to light, decreased stretch reflexes, hypothermia and absent Moro.