A variation of expectant management that is used by
many practitioners who may consider their management
style to be physiologic rather than active is the BrandtAndrews
manoeuvre. This manoeuvre involves no
administration of oxytocin, and controlled cord traction
with or without early clamping. There currently is no
research that compares the Brandt-Andrews manoeuvre
to physiologic management of third stage. Both
approaches seem to be reasonable variations to offer
when a woman has chosen physiological management,
given the evidence discussed earlier in this guideline
that suggests that controlled cord traction decreases the
risk of PPH.