There is a gap in current research regarding what impact
each of the individual components of active
management has on preventing blood loss. It appears
that the key element of active management is the
administration of an oxytocic drug, but evaluation of the
other components of active management is
incomplete.28,29 Subsequent sections of this guideline
review the evidence regarding each of the components
of active management. While future research may
define the components of active management that are
most effective in preventing PPH and which, if any, hold
risk if used incorrectly or alone,30,31 current evidence
suggests that active management of the third stage is the
most effective tool in preventing PPH and adverse
sequelae. Informed choice discussions with women
regarding active management of third stage must be
documented in the woman’s chart.