Intraumbilical veinous injection oxytocin in the active management of third stage of labour.

OBJECTIVE To determine the role of intraumbilical vein oxytocin reducing blood loss during and after one hour of delivery of placenta and its efficacy in reducing the frequency of retained placenta. STUDY DESIGN Randomized controlled trial. PLACE AND DURATION OF STUDY Combined Military Hospital, Multan, from June 2002 to October 2002. METHODOLOGY Five hundred parturient women with low risk singleton term pregnancy were enrolled in the study. Two hundred and fifty women each were included in the study and control group after randomization. The patients and health care providers both were blinded to the intervention. Primary outcome measures were kept as duration and amount of blood loss in third stage of labour. Secondary outcome measures included incidence of retained placenta, abdominal need for additional utero-tonics, frequency of postpartum pain, nausea and vomiting, fever, need for blood transfusion, establishment of breast feeding and total duration of hospital stay. RESULTS Women in study group who received intraumbilical vein syntocinon lost 234.03 ml of blood while the control group lost 276.51 ml (p=0.001). Mean duration of third stage was 2.59 minutes in the study group and 7.67 minutes in the control group (p<0.001). The frequency of retained placenta was 1.2%, which involved only the control group. Abdominal pain was experienced by study group but the difference was not found statistically significant. Nausea and vomiting was more in study group (p=0.001). No discernible difference was found in length of hospital stay, the need for blood transfusion, fever and establishment of breast-feeding in both groups. CONCLUSION The addition of intraumbilical vein syntocinon 10 units resulted in marked reduction in amount of blood loss, duration of third stage and incidence of retained placenta in comparison to intravenous 5 IU oxytocin+0.5 mg ergometrine alone.