Submited on: 04 Mar 2012 02:56:56 PM GMT
Published on: 05 Mar 2012 01:33:59 PM GMT
 
Review of 3-4-5 technique for management of 3rd stage of labor
Posted by Ms. P F Halaby on 11 Nov 2014 01:23:42 AM GMT Reviewed by Interested Peers

  • What are the main claims of the paper and how important are they?

    This paper claims to have an easily taught and reproducible protocol for managing delivery of the placenta and keeping PPH rates lower than those seen with standard active or expectant management protocols. It also points out that active management and expectant management are not uniformly understood or practiced per guidelines.


  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    I find this concept to be a novel one as I have been in practice clinical practice where everyone uses "active" management - which just means pull on the cord as hard as you can right after the baby comes out!


  • Are the claims properly placed in the context of the previous literature?

    Yes, as far as I can tell


  • Do the results support the claims? If not, what other evidence is required?

    Yes


  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    Not that I can tell


  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    I believe so, I am going to adopt this protocol in my practice


  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    Not that I can tell. The only thing that could improve it would be to do a bigger study.


  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    I really like the simplicity of the protocol, the fact that it seems to work, and is easy to remember


  • Other Comments:

    no

  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Delivery of over 1600 babies in home and hospital settings

  • How to cite:  Halaby P F.Review of 3-4-5 technique for management of 3rd stage of labor[Review of the article 'Judys 3-4-5 Protocol: Combining the Best Parts of Active and Expectant Management of Third Stage of Labor for Lowest PPH > 500 cc and no PPH >1000 cc ' by Cohain J].WebmedCentral 2014;5(11):WMCRW003133
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1 Is the subject of the article within the scope of the subject category? Yes
2 Are the interpretations / conclusions sound and justified by the data? Yes
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? Yes
5 Are structure and length satisfactory? Yes
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? Yes
8 Is the quality of the diction satisfactory? Yes
9 Are the illustrations and tables necessary and acceptable? Yes
10 Are the references adequate and are they all necessary? Yes
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    Judy Cohain's original research on third stage labor is a needed contribution to the void that exists on this topic. As stated in her article, this subject is of utmost importance to practitoners wanting to help usher in the best physical and emotional health for the new mother-baby dyad. 

     

    Her research delineates a simple method of prevention of PPH, with very effective results. This method not only  adds to the repertoire of techiques for practitioners--it becomes the intervention of choice. 

    Low-tech, hi-touch practitioners will particularly welcome this research, as well as providers in resource-poor, developing nations. 

     

  • Competing interests:
    None
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    This article directly addresses my area of science--the midwifery model of care.

  • How to cite:  Allen L H.Judys 3-4-5 Protocol: Combining the Best Parts of Active and Expectant Management of Third Stage of Labor for Lowest PPH>500cc and no PPH>1000cc[Review of the article 'Judys 3-4-5 Protocol: Combining the Best Parts of Active and Expectant Management of Third Stage of Labor for Lowest PPH > 500 cc and no PPH >1000 cc ' by Cohain J].WebmedCentral 2014;3(3):WMCRW001572
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