Intraumbilical Vein Injection of Oxytocin in Routine Practice for Active Management of the Third Stage of Labor
Status:
Completed
Trial end date:
2010-03-01
Target enrollment:
Participant gender:
Summary
During the first hours that follow the birth of the baby (third and fourth stages of labor),
complications are common and can threaten the mother's life. The most common complication is
postpartum hemorrhage (PPH), which remains a leading cause of maternal mortality (25.0%)
especially in developing countries .Three to five percent of deliveries are complicated by
PPH and is 50 times more common in developing countries. Retained placenta is an another
complication of third stage of labor. It complicates 0.1-2 % of deliveries . Without prompt
treatment, women are at high risk of hemorrhage. At present, treatment is by manual removal
of placenta, which needs an operating theatre, a surgeon, and an anaesthetist-facilities that
are often unavailable to women in resource-poor settings. As a result, this condition has a
case fatality rate of nearly 10% in rural communities.
The length of the third stage of labor, and its subsequent complications depends on a
combination of the length of time it takes for placental separation and the ability of the
uterine muscle to contract. Principal management of the third stage of labor is aimed at
reducing the time of delivery of placenta so minimising serious adverse effects, such as
blood loss and retained placenta. Active management of the third stage of labor, which
includes prophylactic injection of 10 units of oxytocin within two minutes of birth, early
clamping of the umbilical cord and controlled cord traction (CCT), is recommended by WHO for
PPH prevention .
Umbilical vein oxytocin injection directs the treatment to the placental bed and uterine
wall, resulting in an earlier uterine contraction and placental separation. However, very
limited published literature is available, which evaluated the effect of umbilical vein
oxytocin injection in routine practices for active management of the third stage of labor.
The purpose of this investigation was to find out the beneficial effect of adding
intraumbilical vein oxytocin in reducing the blood loss during third and fourth stages of
labor, length of third stage of labor, and reduction in the incidence of manual removal of
retained placenta.