Aim: To compare the Active Management of the Third Period of Childbirth (AMTPC) with or without uterine massage in the obstetrics department of the C.H.U at Point "G" Bamako / Mali. Patients and methods: this was a randomized, open and controlled test which took place from May 1 to September 01, 2019 (4 months).Parturients in good health (without pathologies related to pregnancy with Glasgow 15 out of 15), consenting, carrying a pregnancy of at least 37 weeks of amenorrhea in presentation of the summit, coming to give birth were included. Data analysis and processing was done on Word 2013 and SPSS 12.0. Tests used: chi-square, P <0.05 (was considered significant). During our study, we identified 891 parturients for 4 months, either 7.4 deliveries per day. Out of 891 parturients we selected 200 parturients including 100 for each arm according to the inclusion and exclusion criteria. The risk factors were represented by primipara in 42% of cases and 45% of witnesses (patients). Postpartum hemorrhage (PPH) was found in 8% of witnesses, however we did not observe PPH in cases with P <0.001. We noted 9% severe anemia in the postpartum period in witnesses, however there was no severe anemia in the cases with P <0.001. We had 5% uterine atony in the witnesses, however there was no case of uterine atony in the cases, P< 0.05. We had 9 witnesses parturients were transfused with P <0.00. 5 witnesses received an additional administration of oxytocin with P <0.05. We did not note any maternal deaths during our study. Conclusion: Active management of the third period of childbirth without uterine massage is more effective than active management of the third period of childbirth with uterine massage in combating postpartum hemorrhage as it results in less postpartum hemorrhage, less transfusion, less use of uterotonics.
