Comparison of Postpartum Blood Loss between Intravenous Oxytocin and Intravenous Methylergometrine Maleate during Third Stage of Labor
Keywords:
Postpartum hemorrhage, Ergometrine, Oxytocin, Third stage of laborAbstract
Objective: To compare postpartum blood loss and side effects between parturients receiving intravenous oxytocin (WHO recommendation) with intravenous methylergometrine maleate (ergometrine) (Ramathibodi Hospital regimen) immediately after child birth.
Methods: The prospective randomized study of 80 parturients assigned to receive either oxytocin or ergometrine in the third stage of labor. All parturient were managed during first stage and second stage of labor according to the regimen of active management of labor (AMOL). Outcome measures were the postpartum blood loss, duration of third stage of labor, side effects of drug, and complications of delivery. Chi-square and t-test were used for hypothesis testing at level = 0.05.
Results: There was on significant difference in postpartum blood loss between the 2 groups. In ergometrine group, longer duration of third stage of labor was observed with more elevated systolic blood pressure and pulse rate than in oxytocin group more uterotonic drugs were added after devilry.
Conclusion: Oxytocin and ergometrine administered immediately after birth showed no difference in postpartum blood loss.
References
Vaid A, Dadhwal V, Mittal S, Deka D, Misra R, Sharma JB, et al. A randomized controlled trial of prophylactic sublingual misoprostol versus intramuscular methyl-ergometrine versus intramuscular 15-methyl PGF2alpha in active management of third stage of labor. Arch Gynecol Obstet. 2009;280(6):893-7. doi:10.1007/s00404-009-1019-y.
Department of Obstetrics and Gynecology. Annual Report. Faculty of Medicine Ramathibodi Hospital, Mahidol University; 2008.
O’Driscoll K, Meagher D. Active Management of Labour: the Dublin Experience. 2nd ed. London: Balliére Tindall; 1986.
World Health Organization. WHO Guidelines for the Management of Postpartum Haemorrhage and Retained Placenta. Geneva: Department of Reproductive Health and Research, World Health Organization; 2009. Available from: https://apps.who.int/iris/bitstream/handle/10665/44171/9789241598514_eng.pdf?sequence=1.
Orji E, Agwu F, Loto O, Olaleye O. A randomized comparative study of prophylactic oxytocin versus ergometrine in the third stage of labor. Int J Gynaecol Obstet. 2008;101(2):129-32. doi:10.1016/j.ijgo.2007.11.009.
Choy CM, Lau WC, Tam WH, Yuen PM. A randomised controlled trial of intramuscular syntometrine and intravenous oxytocin in the management of the third stage of labour. BJOG. 2002;109(2):173-7. doi:10.1111/j.1471-0528.2002.01204.x.
Singh G, Radhakrishnan G, Guleria K. Comparison of sublingual misoprostol, intravenous oxytocin, and intravenous methylergometrine in active management of the third stage of labor. Int J Gynaecol Obstet. 2009;107(2):130-4. doi:10.1016/j.ijgo.2009.06.007.
Soriano D, Dulitzki M, Schiff E, Barkai G, Mashiach S, Seidman DS. A prospective cohort study of oxytocin plus ergometrine compared with oxytocin alone for prevention of postpartum haemorrhage. Br J Obstet Gynaecol. 1996;103(11):1068-73.
Cotter AM, Ness A, Tolosa JE. Prophylactic oxytocin for the third stage of labour. Cochrane Database Syst Rev. 2010;(2):CD001808.
Secher NJ, Arnsbo P, Wallin L. Haemodynamic effects of oxytocin (syntocinon) and methyl ergometrine (methergin) on the systemic and pulmonary circulations of pregnant anaesthetized women. Acta Obstet Gynecol Scand. 1978;57(2):97-103. doi:10.3109/00016347809155884.
Svanström MC, Biber B, Hanes M, Johansson G, Näslund U, Bålfors EM. Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during Caesarean section. Br J Anaesth. 2008;100(5):683-9. doi:10.1093/bja/aen071.
Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Obetetrical Hemorrhage. Williams obstetrics. 23rd ed. New York: McGraw-Hill; 2010:757-803.
Yuen PM, Chan NS, Yim SF, Chang AM. A randomised double blind comparison of Syntometrine and Syntocinon in the management of the third stage of labour. Br J Obstet Gynaecol. 1995;102(5):377-80.
McDonald SJ, Prendiville WJ, Blair E. Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of third stage of labour. BMJ. 1993;307(6913):1167-71. doi:10.1136/bmj.307.6913.1167.