Publication:

The third stage of labour: to bleed or not to bleed - revised role of intra-umbilical oxytocin in management of third stage of labour

Background Background and

Objectives Postpartum haemorrhage is a single largest and leading cause of maternal morbidity and mortality not only in developing countries but also in developed countries. Every 4 minutes one woman dies from pregnancy or child birth related complications. The present study is an attempt to evaluate the scope of using intraumbilical vs intravenous vs intramuscular injection oxytocin for the active management of third stage of labour.

Methods Six hundred pregnant women at term of a singleton pregnancy with spontaneous onset of labour were included in the study and were randomly divided into 3 groups of 200 women each. Group 1, intraumbilical oxytocin 10U diluted in 10ml of saline, Group 2, intravenous oxytocin 10U and Group 3, intramuscular oxytocin 10U were given after the delivery of baby. The outcome criteria’s with respect to third stage of labour were: duration of the 3rd stage of labour, blood loss by volume, difference in haemoglobin. A significant reduction in duration of third stage (p = 0.001) and blood loss in third stage (p =0.0001) in intraumbilical oxytocin group was found when compared with intravenous oxytocin and intramuscular oxytocin.

Conclusions Intraumbilical oxytocin is better alternative to intramuscular oxytocin and intravenous oxytocinin active management of third stage of labour.