The third stage of labour: to bleed or not to bleed - revised role of intra-umbilical oxytocin in management of third stage of labour

Authors

  • Athokpam Manjushree Devi Department of Obstetrics and Gynecology, K Muzaffarnagar Medical College, Beghrajpur Industrial Area, Muzaffarnagar, Uttar Pradesh, India
  • Kriti Bhatnagar Department of Obstetrics and Gynecology, K Muzaffarnagar Medical College, Beghrajpur Industrial Area, Muzaffarnagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20171962

Keywords:

Postpartum haemorrhage, Intraumbilical oxytocin, Intramascular oxytocin, Intravascular oxytocin

Abstract

Background: Background and Objectives: Postpartum haemorrhage is a single largest and leading cause of maternal morbidity and mortality not only in developing countries but also in developed countries. Every 4 minutes one woman dies from pregnancy or child birth related complications. The present study is an attempt to evaluate the scope of using intraumbilical vs intravenous vs intramuscular injection oxytocin for the active management of third stage of labour.

Methods: Six hundred pregnant women at term of a singleton pregnancy with spontaneous onset of labour were included in the study and were randomly divided into 3 groups of 200 women each. Group 1, intraumbilical oxytocin 10U diluted in 10ml of saline, Group 2, intravenous oxytocin 10U and Group 3, intramuscular oxytocin 10U were given after the delivery of baby. The outcome criteria’s with respect to third stage of labour were: duration of the 3rd stage of labour, blood loss by volume, difference in haemoglobin. A significant reduction in duration of third stage (p = 0.001) and blood loss in third stage (p =0.0001) in intraumbilical oxytocin group was found when compared with intravenous oxytocin and intramuscular oxytocin.

Conclusions: Intraumbilical oxytocin is better alternative to intramuscular oxytocin and intravenous oxytocinin active management of third stage of labour. 

References

Puri M, Taneja P, Gami N, Rehan HS. Effects of different doses of intraumbilical oxytocin on the third stage of labor. International journal of Gynaecology and obstetrics. 2012;118(3):210-2.

Mukherjee J, Ganguli RP, Saha SR. Maternal Mortality due to haemorrhage with emphasis on PPH. Journal Obst. Gynaecol India. 2001;57(5):130-3.

WHO, UNICEF, UNFPA, The World Bank, and the United Nations Population Division. Trends in Maternal Mortality: 1990 to 2013. Geneva, World Health Organization, 2014.

Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. William's Obstetrics, 23rd Ed. McGraw-Hill Professional, Philadelphia; 2010:310-335.

Desai S, Jani NS. PPH in pregnancy in pregnancy induced hypertension (ed) Hypertensive disorder in pregnancy, New Delhi. JP Bros, 2007.

Dahiya P, Puri M, Rathee S. Influence of intraumbilical oxytocin on the third stage of labour. Ind Journal of Medical Sciences. 1995;49:2(23).

Kore S, Srikrishna S, Hedge A, AmbiyeVR VP. Active management of third stage of labour with intraumbilical oxytocin injection. J Obstet Gynaecol India. 2000;50(3):54-5.

Shrestha P, Babu CS. Influence of umbilical vein oxytocin on blood loss and length of third stage of labour. Nepal Med Coll J; 2007.

Ojha N, Malla DS. Active management of third stage of labour by oxytocin: Umbilical vein versus intramuscular use. N. J. Obstet. Gynaecol; 2007:13- 16.

Manhas A, Habib H. A Randomized Controlled Study of Prophylactic Use of Umbilical Vein Oxytocin in The Management of Third Stage of Labor. IOSR Journal of Dental and Medical Sciences; 2012.

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Published

2017-04-27

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Original Research Articles