A comparison of prophylactic intramuscular ergometrine and oxytocin for women in the third stage of labor.

Authors:
Dr Ahizechukwu C Eke, MD, MPH, FWACS
Dr Ahizechukwu C Eke, MD, MPH, FWACS
Division of Maternal Fetal Medicine & Clinical Pharmacology, Johns Hopkins University School of Medicine, 600 N Wolfe Street
Maternal Fetal Medicine
Baltimore, Maryland | United States

Int J Gynaecol Obstet 2014 Jan 5;124(1):67-71. Epub 2013 Oct 5.

Department of Obstetrics and Gynecology, Michigan State University/Sparrow Hospital, Lansing, USA.

Objective: To compare the efficacy and adverse effects of ergometrine and oxytocin given intramuscularly for the prevention of postpartum hemorrhage during the third stage of labor.

Methods: The study included women with a singleton pregnancy of at least 28 weeks' gestation who had a vaginal delivery. High-risk pregnancies were excluded. Oxytocin (10 IU) or ergometrine (0.5mg) were administered intramuscularly in a blinded pattern immediately after delivery of the infant. An intention-to-treat analysis was performed.

Results: Postpartum blood loss (301.8 ± 109.2 mL versus 287.1 ± 84.4 mL, P=0.011) and packed cell volume (30.7 ± 1.7% versus 31.6 ± 2.0%; Z=0.00; P=0.008) were considerably reduced among parturients who received intramuscular ergometrine. The rates of therapeutic oxytocics use, blood transfusion, placental retention, and manual removal of the placenta were significantly higher in the oxytocin group. No significant differences between the groups were observed in terms of adverse effects, with the exception of diastolic hypertension, which was more common in the ergometrine group (odds ratio, 0.00; 95% confidence interval, 0.00-0.75; P=0.007).

Conclusion: Intramuscular ergometrine is superior to intramuscular oxytocin in averting postpartum hemorrhage during the third stage of labor. There are no significant risks of adverse effects except for diastolic hypertension.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijgo.2013.07.020DOI Listing
January 2014
34 Reads
1.563 Impact Factor

Publication Analysis

Top Keywords

intramuscular ergometrine
12
adverse effects
12
third stage
12
postpartum hemorrhage
8
diastolic hypertension
8
stage labor
8
ergometrine oxytocin
8
hemorrhage third
8
ergometrine
6
oxytocin
5
common ergometrine
4
versus 2871
4
2871 844
4
ergometrine group
4
844 p=0011
4
cell volume
4
volume 307
4
307 17%
4
group odds
4
packed cell
4

References

(Supplied by CrossRef)
Primary postpartum haemorrhage
Selo-Ojeme et al.
J Obstet Gynaecol 2002

AbouZahr et al.
1998
Epidemiology of postpartum haemorrhage: a systematic review
Carroli et al.
Best Pract Res Clin Obstet Gynaecol 2008
Active versus expectant management in the third stage of labour
Prendiville et al.
Cochrane Database Syst Rev 2000
Prophylactic use of oxytocin in the third stage of labour
Elbourne et al.
Cochrane Database Syst Rev 2001

Similar Publications