Efficacy of intraumbilical vein (IUV) injection of oxytocin in active management of the third stage of labor

Abstract

Assessment of the efficacy of using intraumbilical vein (IUV) injection of Oxytocin in active management of the third stage of labor and reducing blood loss and length of the third stage. In a randomized double-blind clinical trial, 200wemen undergoing vaginal delivery without any risk factor for postpartum hemorrhage recruited. 100 assigned to receive 10 international units (IU) oxytocin diluted in 9cc ringer by IUV injection and 10cc ringer by peripheral vein injection and 100 assigned to receive 10cc ringer by IUV injection and 10 international units (IU) oxytocin diluted in 9cc ringer by peripheral vein injection. Active management of labor (prophylactic injection of 20IU oxytocin after clamping of umbilical cord and controlled cord traction) was used in both groups. Pre delivery and post delivery hemoglobin level was assessed. The primary outcome was change in hemoglobin levels and duration of the third stage of labor. The third stage of labor was significantly shorter in IUV injection group (4.2 +/- 4.1 minutes compared with 5.5 +/- 4.5 minutes, respectively; p=0.03). An additional uterotonic agent in case group was needed less than the controlled group (P=0.03). Mean drop in hemoglobin levels in intervention group was 1.5 +/- 0.96 (95% CI 1.16-1.53) and in control group was 1.35 +/- 0.94 (95% CI 1.3-1.7) and there was significantly difference in this respect in two groups (p-value = 0.228). IUV injection of Oxytocin with the active management of the third stage of labor significantly reduced the rate of additional uterotonic agents and duration of third stage of labor. The hemoglobin reduce in the intervention group was lower compared to the control group but this difference was not analytically meaningful. Need to manual removal of the placenta, Hb levels after 24 hours after delivery, and placenta emersion time more than 15 minutes was lower in the group receiving oxytocin but the difference was not significant. [Farideh Movahed, Reyhaneh Ramazan Nejhad, Ezzatalsadat Haji Seid Javadi, Amir Javadi, Fatemeh Lalooha, Omid Mashrabi. Efficacy of intraumbilical vein (IUV) injection of oxytocin in active management of the third stage of labor. Life Sci J 2012;9(4):1242-1246] (ISSN:1097-8135). http://www.lifesciencesite.com. 186