OJOG  Vol.4 No.11 , August 2014
Oxytocin versus Methylergometrine in the Active Management of Third Stage of Labour
ABSTRACT

Objective: To compare the efficacy of Oxytocin versus Methylergometrine in active management of third stage of labour in reducing risk of postpartum hemorrhage. Methods: This study was carried out by randomly assigning into two groups with 150 women in each group. Group 1 included patients who received injection Oxytocin 10 IU intramuscular within one minute of the birth of the baby. Injection Methylergometrine (0.2 mg) was given intravenously at the delivery of anterior shoulder of the baby to women in Group 2. Outcome measures were the duration of third stage, blood loss, pre and post-delivery hematocrit, side effects and incidence of PPH. Statistical analysis was done using Chi square test, Fischers test, Mann Whitney test, and t test. p < 0.05 was considered significant. Results: Mean duration of third stage of labour, mean blood loss, post-delivery fall in hematocrit and need for additional uterotonics were significantly less in the Group 2. However side effects like nausea, vomiting and rise in blood pressure were significantly higher in women in Group 2 (p = 0.000). Conclusion: Methylergometrine is more effective than Oxytocin in reducing the duration of third stage of labour and blood loss but has significant side effects like nausea, vomiting and rise in blood pressure.


Cite this paper
Boopathi, A. , Nayak, S. , Rao, A. and Rao, B. (2014) Oxytocin versus Methylergometrine in the Active Management of Third Stage of Labour. Open Journal of Obstetrics and Gynecology, 4, 666-671. doi: 10.4236/ojog.2014.411093.
References
[1]   Dongol, A.S., Shrestha, A. and Chawla, C.D. (2010) Post Partum Haemorrhage: Prevalence, Morbidity and Management Pattern in Dhulikhel Hospital. Kathmandu University Medical Journal (KUMJ), 8, 212-215. http://dx.doi.org/10.3126/kumj.v8i2.3561

[2]   Abou Zahr, C. (2003) Global Burden of Maternal Death and Disability. World Health Organization, Geneva, Switzerland. British Medical Bulletin, 67, 1-11. http://dx.doi.org/10.1093/bmb/ldg015

[3]   World Health Organization (2012) World Health Organization Multicountry Survey on Maternal and Newborn Health. WHO, Geneva.

[4]   Tsu, V.D., Levin, C., Tran, M.P., Hoang, M.V. and Luu, H.T. (2009) Cost-Effectiveness Analysis of Active Management of Third-Stage Labour in Vietnam. Health Policy Plan, 24, 438-444.
http://dx.doi.org/10.1093/heapol/czp020

[5]   Winter, C., Macfarlane, A., Deneux-Tharaux, C., Zhang, W.H., Alexander, S., Brocklehurst, P., et al. (2007) Variations in Policies for Management of the Third Stage of Labour and the Immediate Management of Postpartum Haemorrhage in Europe. BJOG, 114, 845-854.
http://dx.doi.org/10.1111/j.1471-0528.2007.01377.x

[6]   Festin, M.R., Lumbiganon, P., Tolosa, J.E., Finney, K.A., Ba-Thike, K., Chipato, T., et al. (2003) International Survey on Variations in Practice of the Management of the Third Stage of Labour. Bulletin of the World Health Organization, 81, 286-291.

[7]   Dumoulin, J.G. (1981) A Reappraisal of the Use of Ergometrine. Journal of Obstetrics and Gynecology, 1, 178-181. http://dx.doi.org/10.3109/01443618109067375

[8]   Embrey, M.P. (1961) Simultaneous Intramuscular Injection of Oxytocin and Ergometrine: Atocographic Study. BMJ, 1, 1737-1738. http://dx.doi.org/10.1136/bmj.1.5241.1737

[9]   McDonald, S., Prendville, W.J. and Elbourne, D. (2001) Prophylactic Syntometrine versus Oxytocin for Delivery of the Placenta. The Cochrane Database of Systematic Reviews, 1, Article ID: CD000201.

[10]   Suellen, M., et al. (2004) A Cochrane Review Metaanalysis. New Advances for Low-Resource Settings: Uterotonics for Prevention of Postpartum Hemorrhage. Journal of Midwifery & Women’s Health, 49, 283-292. http://dx.doi.org/10.1016/j.jmwh.2004.04.001

[11]   Bugalho, A., Daniel, A., Faundes, A. and Cunha, M. (2001) Misoprostol for Prevention of Postpartum Hemorrhage. International Journal of Gynecology Obstetrics, 73, 1-6.
http://dx.doi.org/10.1016/S0020-7292(01)00346-0

[12]   Choy, C.M., Lau, W.C., Tam, W.H. and Yuen, P.M. (2002) A Randomized Controlled Trial of Intramuscular Syntometrine and Intravenous Oxytocin in the Management of the Third Stage of Labour. BJOG, 109, 173-177. http://dx.doi.org/10.1111/j.1471-0528.2002.01204.x

[13]   Orji, E., Agwu, F., Loto, O. and Olaleye, O. (2008) A Randomised Comparative Study of Prophylactic Oxytocin versus Ergometrine in the Third Stage of Labour. International Journal of Gynecology Obstetrics, 101, 129-132. http://dx.doi.org/10.1016/j.ijgo.2007.11.009

[14]   Malkawi, H., Hindawi, I., Hiasat, M. and Amarin, V. (2005) Oxytocin and Syntometrine in Prevention of Postpartum Hemorrhage. JRMS, 12, 75-77.

 
 
Top