DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20181934

A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour

Devi Reddy Hema Swapnika, Prema Priya G., S. Senthil Priya, A. S. Allirathinam

Abstract


Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.

Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.

Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.

Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage.


Keywords


Active management of third stage of labour, Methyl ergometrine, Oxytocin, Post partum haemorrhage

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References


India Maternal mortality rate – Demographics [Internet]. [cited July 9, 2017]. Available at https://www.indexmundi.com/india/maternal_mortality_rate.html

The World Health Report 2005 - make every mother and child count [Internet]. [cited 2014 Sep 3]. Available at http://www.who.int/whr/2005/en/

Dutta DC. Textbook of Obstetrics. 7th Edition, New Central Book Agency Pvt. Ltd;2011:117-42.

Arulkumaran S, Arjun G, Penna LK. The management of labour. 3rd Ed. Hyderabad: universities press (India) private Ltd;2011;18:289-295.

World Health Organization. WHO Issue recommendations for postpartum haemorrhage. Geneva-2012 [internet] [cited 2014 Sep 1] Available at www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/

FIGO Guidelines on the prevention and treatment of postpartum haemorrhage in Low-Resource settings [Internet]. [cited 2014 Sep 2]. Available at http://www.fogsi.org/index.php?option=com_content&view=article&id=351 %3A figo-guidelines-on-the-prevention-and-treatment-of-postpartum haemorrhage-in-low-resorce settings&catid =39%3A miscellanea & Itemid=238.

The Cochrane Collaboration, editor. Cochrane Database of Systemic Reviews: reviews [Internet]. Chichester, UK:John Wiley and Sons, Ltd; 1996 [cited 2014 sep 3]. Available at http://apps.whoint/rhUguidelines/appraisal_pph/en/index.html

Active versus expectant management for women in the third stage of labour. [inteme] [cited 2014 sep 14] Available at http://apps.who.int/rhl/pregnancy_childbirth /3rd_stage/cd007412_abalose_ com/en/

Foley MR, Strong TH, Garite TJ. McGraw Hill Professional, 2004. Obstetric Intensive Care Manual 2nd edition. 2004; 24-7

American College of Obstetricians and Gynecologists. ACOG Practice Bulletin: Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006 Oct;108(4):1039-47.

Combs CA. Factors associated with postpartum haemorrhage with vaginal birth. Obstet Gynecol 1991;77:69-76.

Rajendran D, Mamatha S, Siddesh A, Gowda S. Oxytocin versus methyl ergometrine in the management of third stage of labor: a comparative study from a South Indian tertiary care hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5:1327-30.

Vandana Satwe, Jyoti Salunkhe, Seema Satwe, Sheetal Samson. Injection Oxytocin versus Injection Methergine in Active Management of Third Stage of Labour. IJSR. 2014;3(3):353-8.

Adhikari S, Rana A, Bista KD. Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin. Nepal J Obstet Gynaecol. 2007;2(2):24-8.