Effect of Umbilical Vein Oxytocin Injection on the Third Stage of Labor: A Randomized Double-blinded Placebo Controlled Trial

Abstract

Objective : To evaluate the effect of umbilical vein oxytocin injection on the third stage of labor in reducing blood loss, duration of the third stage, retain placenta and side effect .

Methods : The study is prospective, randomized, double-blinded placebo controlled trial at Nakhonpathom hospital. In 2010, the women undergoing vaginal delivery were randomly allocated into two groups, 30 women each, to receive either 20 ml 0.9% normal saline (control group n = 30) or 20 international units oxytocin (2 ml) diluted with 18 ml of 0.9% normal saline (study group n = 30) by intraumbilical vein injection. The primary outcomes were mean blood loss during the third stage of labor, duration of the third stage, retain placenta and side effects.

Results : The mean estimated blood loss was significantly lower in women treated with oxytocin compared with women in the control group (118.3 ± 26.4 ml compared with 284.7 ± 96.0 ml, respectively; P < 0.001). The third stage of labor was significantly shorter in the study group than in the control group (6.7 ± 2.6 minutes compared with 21.5 ± 13.8 minutes, respectively; P < 0.001). The percentages of placenta remaining undelivered beyond 30 minutes were 0% in the study group and 3% in the control group (P = 0.999). The only 1 case of the study group had abdominal discomfort but not statistically different.

 Conclusion : The using of intraumbilical injection of oxytocin significantly reduced postpartum blood loss and the duration of the third stage of labor. This procedure may benefit to reduce rate of postpartum hemorrhage.