Umbilical Oxytocin in the 3rd stage of labour (A substitute to minimize the risk of PPH)

Abstract

 Objective: The aim of this study is to evaluate the efficacy of intra umbilical injection of oxytocin on shortening of the 3rd stage duration, minimizing the blood loss during the 3rd and 4th stages of labour, minimizing the risk of post- partum hemorrhage and retained placenta, found an alternative method for active management of 3rd stage where ergometrine is contraindicated e.g. hypertension, cardiac disease. Material & Methods: across sectional prospective study on 100 pregnant ladies in the period between July and August 2012 whose presented for vaginal delivery in labour suite in Aljalaa Maternity Hospital, Tripoli – Libya, exclusion criteria are those associated with risk of hemorrhage such as multiple gestation, preeclampsia, antepartum hemorrhage, and coagulopathy, after enrollment the patient was excluded if C/S is indicated. The cases are divided into two groups (50 cases each), Group A: expectant management was applied via giving 0.4 mg Ergometrine IM after placental delivery,Group B: 20 IU Oxytocin injected into the umbilical vein within 30 seconds of the delivery of the baby and cord clamping, the amount of blood loss during the 3rd and 4th stage of labour was estimated and the time taken for placenta to be delivered was recorded for both groups,Hb concentration was measured and then compared with pre- delivery hemoglobin. Results:The incidence of PPH is high in our hospital compared with international figures, blood loss > 500 ml was more (2 fold) in group A, the duration of 3rd stage was significantly less (3fold) with group B, side effects (e.g. nausea and raised BP) were more with group A, 1, There was no significant difference in hemoglobin level reduction.