Care during childbirth

Care during labour - first stage

• Amniotomy for shortening spontaneous labour
• Continuous cardiotocography (CTG) as a form of electronic monitoring (EFM) for fetal assessment during labour
• Continuous support for women during childbirth
• Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care
• Effect of partogram use on outcomes for women in spontaneous labour at term
• Maternal positions and mobility during first stage of labour
• Vaginal chlorhexidine during labour for preventing maternal and neonatal infections (excluding Group B Streptococcal and HIV)

Babies with specific conditions during labour

• Amnioinfusion for meconium-stained amniotic fluid
• Amnioinfusion for potential or suspected umbilical cord compression in labour

Abnormal presentations and positions of the baby

• External cephalic version for the management of breech presentation
• Planned caesarean section for term breech delivery

Care during labour - second stage

• Episiotomy for vaginal birth
• Intrapartum interventions for preventing shoulder dystocia
• Position in the second stage of labour for women without epidural anaesthesia
• Vacuum extraction versus forceps for assisted vaginal delivery

Perineal trauma

• Absorbable suture materials for primary repair of episiotomy and second degree tears
• Methods of repair for obstetric anal sphincter injury

Caesarean section

• Alternative techniques and materials for caesarean section
• Antibiotic prophylaxis for caesarean section
• Early compared with delayed oral fluids and food after caesarean section
• Maternal position during caesarean section for preventing maternal and neonatal complications
• Methods of delivering the placenta at caesarean section
• Regional versus general anaesthesia for caesarean section
• Spinal versus epidural anaesthesia for caesarean section
• Surgical techniques for caesarean section

Care during labour - third stage

• Active versus expectant management in the third stage of labour
• Choice of uterotonic agents in the active management of the third stage of labour
• Early versus delayed umbilical cord clamping in preterm infants
• Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcomes
• Uterine massage for preventing postpartum haemorrhage

Postpartum haemorrhage and retained placenta

• Treatment for primary postpartum haemorrhage
• Umbilical vein injection for management of retained placenta