To Compare the Efficacy and Safety of Umbilical Vein Oxytocin Infusion and Intramuscular Oxytocin Administration in Management of Third Stage of Labour
- 1. Senior Resident, Department of Obstetrics & Gynaecology, Hindu Rao Hospital, Delhi, India
- 2. Medical Officer, Department of Obstetrics & Gynaecology, Govt. Multispeciality Hospital, Chandigarh, India
Description
Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality globally, particularly in resource-limited settings. The third stage of labor, encompassing the delivery of the placenta, is a critical period for managing PPH. Oxytocin, a commonly used uterotonic drug, plays a pivotal role in preventing PPH. However, optimal dosages and administration routes for oxytocin remain uncertain. Intraumbilical vein oxytocin injection has emerged as a potential noninvasive method for reducing blood loss and addressing complications like retained placenta. This study aims to evaluate the efficacy and safety of intraumbilical vein oxytocin injection in shortening the third stage of labor and preventing excessive bleeding. Methods: This prospective randomized case-control study involved 220 pregnant women in labor admitted to the Department of Obstetrics and Gynecology at the Government Multispecialty Hospital. Participants meeting specific criteria were allocated to either Group I or Group II using sealed opaque envelopes. Group I received 10 IU of oxytocin diluted in 18 ml of normal saline via the umbilical vein, while Group II received 10 IU of oxytocin intramuscularly at the delivery of the baby’s anterior shoulder. Exclusion criteria were applied to certain medical conditions. Vaginal delivery was conducted, and blood loss was measured using a kidney tray and pre-weighted pads. Pulse rate, blood pressure, temperature, and side effects were recorded. The primary outcomes assessed were blood loss, incidence of PPH, duration of the third stage of labor, and manual removal of the placenta. Statistical analysis was performed using appropriate tests and software. Results: The age distribution, gestational age, gravida, and parity were similar between Group I and Group II. The duration of the third stage of labor showed no significant differences between the two groups, with the most common duration being 5 minutes. The mean duration was 4.57 minutes in Group I and 5.082 minutes in Group II. Interventions and outcomes related to delivery, including episiotomy, tears, intact perineum, mode of placental delivery, and blood loss, were comparable between the groups. There were no cases of severe blood loss (PPH) in either group. These findings indicate similar outcomes in terms of delivery measures and associated interventions. Conclusion: From these observations, it was concluded that intraumbilical oxytocin injection in the third stage of labor is comparable to intramuscular oxytocin injection in the active management of the third stage of labor. Intraumbilical vein oxytocin is considered safe, simple, inexpensive, and noninvasive. Therefore, it can be used as an alternative to the traditional method of intravenous oxytocin infusion in the management of the third stage of labor.
Abstract (English)
Background: Postpartum hemorrhage (PPH) is a leading cause of maternal mortality globally, particularly in resource-limited settings. The third stage of labor, encompassing the delivery of the placenta, is a critical period for managing PPH. Oxytocin, a commonly used uterotonic drug, plays a pivotal role in preventing PPH. However, optimal dosages and administration routes for oxytocin remain uncertain. Intraumbilical vein oxytocin injection has emerged as a potential noninvasive method for reducing blood loss and addressing complications like retained placenta. This study aims to evaluate the efficacy and safety of intraumbilical vein oxytocin injection in shortening the third stage of labor and preventing excessive bleeding. Methods: This prospective randomized case-control study involved 220 pregnant women in labor admitted to the Department of Obstetrics and Gynecology at the Government Multispecialty Hospital. Participants meeting specific criteria were allocated to either Group I or Group II using sealed opaque envelopes. Group I received 10 IU of oxytocin diluted in 18 ml of normal saline via the umbilical vein, while Group II received 10 IU of oxytocin intramuscularly at the delivery of the baby’s anterior shoulder. Exclusion criteria were applied to certain medical conditions. Vaginal delivery was conducted, and blood loss was measured using a kidney tray and pre-weighted pads. Pulse rate, blood pressure, temperature, and side effects were recorded. The primary outcomes assessed were blood loss, incidence of PPH, duration of the third stage of labor, and manual removal of the placenta. Statistical analysis was performed using appropriate tests and software. Results: The age distribution, gestational age, gravida, and parity were similar between Group I and Group II. The duration of the third stage of labor showed no significant differences between the two groups, with the most common duration being 5 minutes. The mean duration was 4.57 minutes in Group I and 5.082 minutes in Group II. Interventions and outcomes related to delivery, including episiotomy, tears, intact perineum, mode of placental delivery, and blood loss, were comparable between the groups. There were no cases of severe blood loss (PPH) in either group. These findings indicate similar outcomes in terms of delivery measures and associated interventions. Conclusion: From these observations, it was concluded that intraumbilical oxytocin injection in the third stage of labor is comparable to intramuscular oxytocin injection in the active management of the third stage of labor. Intraumbilical vein oxytocin is considered safe, simple, inexpensive, and noninvasive. Therefore, it can be used as an alternative to the traditional method of intravenous oxytocin infusion in the management of the third stage of labor.
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IJPCR,Vol15,Issue8,Article29.pdf
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Additional details
Dates
- Accepted
-
2023-06-25
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue8,Article29.pdf
- Development Status
- Active
References
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