Intraumbilical vein oxytocin during third stage of labor

January 01, 0001

Intraumbilical vein oxytocin during third stage of labor

These Turkish investigators conducted a prospective, randomized, double-blind trial to estimate the efficacy of the routine use of intraumbilical vein injection of oxytocin with active management of the third stage of labor in reducing blood loss and length of the third stage. They enrolled 412 women undergoing vaginal delivery who did not have risk factors for postpartum hemorrhage and randomly allocated them to receive either 20 international units oxytocin diluted with 26 mL saline (n=207) or 30 mL saline (n=205) by intraumbilical vein injection. Active management of the third stage of labor (prophylactic injection of 10 international units oxytocin within 2 minutes of birth, early clamping of the umbilical cord, and controlled cord traction) was used in both groups.

They found: "The mean estimated blood loss was significantly lower in women treated with oxytocin compared with women in the placebo group (195.3 mL compared with 288.3 mL, respectively). The third stage of labor was significantly shorter in the oxytocin group than in the placebo group (4.5 minutes compared with 7.9 minutes, respectively). The percentages of placentas remaining undelivered beyond 15 minutes were 0% in the oxytocin group and 4.4% in the placebo group, (significant)."

The authors concluded: "The use of intraumbilical injection of oxytocin with the active management of the third stage of labor significantly reduced postpartum blood loss and the duration of the third stage."

The evidence is good for the use of this approach for management of the third stage of labor.

For the full abstract, click here.

Obstetrics & Gynecology 116(3):619-624, September 2010
© 2010 to the American College of Obstetricians and Gynecologists
Using Intraumbilical Vein Injection of Oxytocin in Routine Practice With Active Management of the Third Stage of Labor: A Randomized Controlled Trial. Kemal Güngördük, Osman Asicioglu, Berhan Besimoglu, et al. Correspondence to Dr. Gungorduk: [email protected]

Category: W. Pregnancy, Childbirth, Family Planning. Keywords: birth, third stage labor, placenta, oxytocin, blood loss, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 5 October 2010

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