الفهرس 
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Abstract
This cross sectional study was carried out at the Department of Obstetrics and Gynecology at Dekernis general Hospital after obtaining an approval of Medical Ethics Committee for Human Research, from March 2014 to December 2015. The study participants were 600 women during their third stage of labour. An informed consent was taken from all enrolled women.
This study was aiming at estimating the specific duration of the third stage of labor above which the risk of increased maternal blood loss is associated.
The method of the study included
calculation of the duration of the third stage of labour by astop watch from the time of delivery of the neonate untill the delivery of the placenta.
Collection of the blood lost during the third stage of labor and calculation of its amount using graduated collection containers and leather sheets designed for vaginal deliveris.
The primary outcome measures focused on the duration of the third stage of labor correlated to vaginal blood loss during the third stage of labor and postpartum heamorrhage.
The secondary outcome measures included required blood transfusion, amount of ecbolics used during the third stage, analgesics used during labor and neonatal outcome measures.
managing the data in a statistical manner to detect the best cutoff duration of 3rd stage at which the risk of PPH increased.
We detected that:
The best cutoff duration of the third stage of labor is 18 minutes after which the placenta should be removed to decrease the risk of PPH.
The risk of PPH also increases with anemia, macrosomia& increased placental weight.
The third stage is prolonged with prematurity, macrosomia and anemia.
Finally Further investigations would encouraged to identify modifiable risk factors and techniques to decrease the risk of postpartum hemorrhage, because it remains as one of the leading causes of maternal death in both developed and nondeveloped countries.