Active management of third stage of labour: a comparative study of intra-umbilical oxytocin versus intramuscular oxytocin

Neerja Gupta, Manjushree Athokpam


Background: Postpartum haemorrhage is a single major and leading cause of maternal morbidity and mortality, not only in the developing countries but also in developed countries. Every 4 minutes one woman dies from pregnancy or child birth related complications. The present study is to compare oxytocin used via intra-umbilical or intramuscular route in the active management of third stage of labour with respect to duration and amount of bleeding.

Methods: Four hundred pregnant women at term of a singleton pregnancy with spontaneous onset of labour were included in the study and were randomly divided into 2 groups of 200 women each. Group 1, intra-umbilical oxytocin 10U diluted in 10ml of saline, and Group 2, intramuscular oxytocin 10U were given after the delivery of baby.

Results: The outcome criteria 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 intra-umbilical oxytocin group was found when compared with intramuscular oxytocin use.

Conclusions: Intra-umbilical oxytocin is better alternative to intramuscular oxytocin in active management of third stage of labour.


Active management of 3rd stage of labour, Caesarian section, Post partum haemorrhage

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Ministry health and family welfare, Press release;2015.

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

Chamberlain G. The clinical aspects of massive haemorrhage. Maternal Mortality-The Way forward London: RCOG. 1992:54-62.

Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. William's Obstetrics, 23nd ed. McGraw-Hill Professional, Philadelphia. 2010:310-35.

Organization WHO. WHO recommendations for the prevention of postpartum haemorrhage. Geneva: World Health Organization: Department of Making Pregnancy Safer; 2007.

Dahiya P, Puri M, Rathee S. Influence of intraumbilical oxytocin on the third stage of labour. Ind J Medic Sci. 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 Gynecol 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 Gynecol. 20074;2(1):13-6.

Manhas A, Habib H. A randomized controlled study of prophylactic use of umbilical vein oxytocin in the management of third stage of labor. IOSR-JDMS. 2012;1(6):27-30.