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

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.

Side-effects of intravenously versus intramuscularly oxytocin for postpartum hemorrhage: a systematic review and meta-analysis of randomized controlled trials

“…We assessed 338 full-texts for eligibility after removing duplicates. Overall, nine studies met inclusion criteria and included, involving 8,295 participants (Figure 1) (Oguz Orhan et al, 2014;Sangkomkamhang and Kruangpatee, 2015;Dagdeviren et al, 2016;Neri-Mejia and Pedraza-Aviles, 2016;Devi and Bhatnagar, 2017;Adnan et al, 2018;Charles et al, 2019;Durocher et al, 2019;Ashwal et al, 2022).…”

“…The median number of sample sizes per study was 450 (range, 43-4,913). Two studies were from Turkey, (Oguz Orhan et al, 2014;Dagdeviren et al, 2016), and other seven studies are from Thailand, (Sangkomkamhang and Kruangpatee, 2015), Mexico, (Neri-Mejia and Pedraza-Aviles, 2016), India, (Devi and Bhatnagar, 2017), Ireland, (Adnan et al, 2018), Eygp, (Charles et al, 2019), Argentina, (Durocher et al, 2019), and Irael, (Ashwal et al, 2022), respectively. All of participants underwent vaginal birth and used standard dose (10 iu).…”