Publication:

Oxytocin versus methyl ergometrine in the management of third stage of labor: a comparative study from a South Indian tertiary care hospital

Background Methyl ergometrine is the conventionally used oxytocic. A few studies have shown that oxytocin is also effective in with fewer adverse effects. This study was carried out to compare the efficacy of oxytocin and methergine in the management of third stage of labor.

Methods 100 pregnant women with gestational age more than 37 weeks were taken up. Excluded were those with polyhydramnios, fibroid complicating pregnancy, intrauterine hemorrhage, antepartum hemorrhage, previous history of postpartum hemorrhage and contraindications to methergine. The subjects were randomised into two groups one given 0.2mg Methylergometrine and the other 10 Units of Oxytocin. The efficacy and the safety of these two drugs were analyzed with respect to fall in Haemoglobin (Hb) and Haematocrit (Hct) level, need for additional uterotonic agents, need for uterine evacuation, need for blood transfusion and duration of third stage of labor.

Results The mean duration of third stage of labor in the methergine group was 6.44 ± 2.426 min and in the oxytocin group 6.28±2.556 min. Mean blood loss was 224.80±50.759 ml and 237.0±69.583 ml. The mean fall in Hb was 0.82±0.29 % and 0.86±0.007%. The mean fall in PCV was 0.93± 0.65 and 0.91±0.64. 6 (6%) in the oxytocin group required additional methergine. 8 (16%) who received methergine had vomiting and 9 (19%) had risen in blood pressure, while those on oxytocin alone did not have any significant adverse effects. Methylergometrine and Oxytocin were equally efficacious in reducing blood loss and duration of third stage of labor.

Conclusions Intramuscular oxytocin is equally effective but has a better safety profile compared to methyl ergometrine and hence is a more preferable prophylactic uterotonic management of the third stage of labor.