A randomised controlled trial of intravenous versus intramuscular oxytocin in the management of third stage of labor.

None listed

Postpartum hemorrhage (PPH) is a significant cause of maternal morbidity and mortality throughout the world especially in developing countries. Uterine atony is the most common etiology. The incidence of postpartum hemorrhage was 3.9% in women delivered vaginally. Active management in third stage of labor is accepted protocol to prevent postpartum hemorrhage. Active management in third stage of labour involves giving a prophylactic uterotonic drug, controlled cord traction to deliver the placenta and uterine massage. Routine oxytocin has been well established. Synthetic oxytocin, acts on the smooth muscle of the uterus to stimulate contractions; especially after term, when adequate oxytocin receptors. When oxytocin binds to oxytocin receptors induces increase intracellular Ca2+ releasing and the increased prostaglandin secretion all contribute to the contractile effects and inhibition of Gamma-Aminobutyric acid (GABA) receptors (this would depolarize if GABA acts as a tonic inhibitory modulator) also causes responses contractions of the uterus. Oxytocin use is advocated either intramuscularly (10 IU) or as a dilute infusion, intravenous bolus has also been used by other authors and they showed an IV bolus of oxytocin 5 to 10 IU, can be used for postpartum hemorrhage prevention after vaginal birth but is not recommended in case of elective cesarean section. At Khon Kaen Hospital guideline recommended 10 units intramuscular oxytocin for routine prophylaxis postpartum hemorrhage. The data of all deliveries in 2010 were collected .We found that postpartum hemorrhage rate 3 % follow vaginal delivery. No maternal death caused from postpartum hemorrhage . We therefore would like to conduct randomized controlled trial to compare the efficacy and safety of intravenous versus intramuscular oxytocin in the management of third stage of labor.

No related papers found yet.