POSTPARTUM HAEMORRHAGE

COMPARISON OF INTRA UMBILICAL AND INTRA VENOUS INJECTION OF OXYTOCIN ON BLOOD LOSS IN THIRD STAGE OF LABOUR

Abstract

The most common complication 0f the third stage of labour is postpartum
haemorrhage, which remains a leading cause of maternal mortality (25.0%), especially in
developing countries. In developed countries, 3-5% of deliveries are complicated by postpartum
haemorrhage: in developing countries, it is 50 times more common .Third stage of labour
which exceeds 30 minutes is associated with a significant risk of postpartum haemorrhage and
puerperal infection. The best preventive strategy for these complications is active management
of third stage of labour. Active management includes administration of oxytocin within one
minute of birth of baby. Objectives: To compare the mean blood loss after administration of
intra umbilical oxytocin versus intravenous oxytocin at anterior shoulder for active management
of third stage of labour. Study Design: Randomized controlled trial. Period: Six months from
1-1-2013 to 30-06-2013. Setting: Department of Obstetrics and Gynaecology, Unit-III Jinnah
Hospital Lahore. Methodology: 100 patients fulfilling selection criteria were included in the
study from labour room. These patients were randomly divided into two groups by using
lottery method. Group-A, 50 patients were administered 10 units of oxytocin diluted in 20ml of
normal saline intraumbilically and group-B, 50 patients were administered 5 units of oxytocin
intravenous stat at anterior shoulder. Total blood loss was noted after complete delivery of
placenta. Results: Mean age was 25.0±3.9 and 24.4±3.5 in group-A and B, respectively. Mean
gestational age was 38.20±0.96 weeks in group-A and 38.40±0.94 weeks in group-B. Mean
blood loss in intraumbilical oxytocin group was 311.20±27.23 ml and in intravenous oxytocin
group mean blood loss was 373.60±66.47 ml. There was statistically significant difference
between two groups (p<0.001). In group-A 15 patients (30.0%) and in group-B 20 patients
(40.0%) were primigravida while remaining patients were multigravida. Conclusion: The usage
of intraumbilical oxytocin in active management of third stage of labour is beneficial in reducing
the blood loss in third stage and thus helps in preventing postpartum haemorrhage.