Skip to main content

Intramuscular versus intravenous prophylactic oxytocin for postpartum hemorrhage after vaginal delivery: a randomized controlled study

Archives of Gynecology and Obstetrics volume 294, pages 911–916 (2016)Cite this article

Abstract

Purpose

Prevention of postpartum haemorrhage (PPH) is essential in the pursuit of improved health care for women. Oxytocin, the most commonly used uterotonic agent to prevent PPH, has no established the route of administration. In this study we aimed to compare whether the mode of oxytocin administration, i.e., intravenous and intramuscular administration, has an effect on the potential benefits and side effects.

Materials and methods

A total of 256 women were randomised into two groups: intramuscular group (128) or intravenous group (128).

Results

Estimated blood loss during the third stage of labour was similar between the two groups (p = 0.572). Further there were no statistically significant difference was noted between the two groups in terms of the mean duration of labor, duration of the third stage of labor, manual removal of the placenta, need for instrumental delivery, need for blood transfusion, PPH ≥500 mL, PPH ≥1000 mL, or length of hospital stay.

Conclusion

Using oxytocin by intravenous and intramuscular route has a similar efficacy and adverse effects.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Priya GP, Veena P, Chaturvedula L, Subitha L (2015) A randomized controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum hemorrhage. Arch Gynecol Obstet 292:1231–1237. doi:10.1007/s00404-015-3763-5

    CAS  Article  PubMed  Google Scholar 

  2. World Health Organization (2009) WHO guidelines for the management of postpartum haemorrhage and retained placenta

  3. Kaul V, Bagga R, Jain V, Gopalan S (2006) The impact of primary postpartum hemorrhage in ‘Near-Miss’ morbidity and mortality in a tertiary care hospital in North India. Indian J Med Sci 60:233–240

    Article  PubMed  Google Scholar 

  4. Lewis G (2007) The Confidential Enquiry into Maternal and Child Health (CEMACH) saving mother’s lives: reviewing maternal deaths to make motherhood safer, 2003–2005. The seventh report on Confidential Enquiry into Maternal Deaths in the United Kingdom. CEMACH, London

    Google Scholar 

  5. Wedisinghe L, Macleod M, Murphy DJ (2008) Use of oxytocin to prevent haemorrhage at caesarean section—a survey of practice in the United Kingdom. Eur J Obstet Gynecol Reprod Biol 137:27–30

    CAS  Article  PubMed  Google Scholar 

  6. Bouwmeester FW, Bolte AC, van Geijn HP (2005) Pharmacological and surgical therapy for primary postpartum hemorrhage. Curr Pharm Des 11:759–773

    CAS  Article  PubMed  Google Scholar 

  7. Davies GA, Tessier JL, Woodman MC, Lipson A, Hahn PM (2005) Maternal hemodynamics after oxytocin bolus compared with infusion in the third stage of labor: a randomized controlled trial. Obstet Gynecol 105:294–299

    CAS  Article  PubMed  Google Scholar 

  8. Miller S, Lester F, Hensleigh P (2004) Prevention and treatment of postpartum hemorrhage: new advances for low-resource settings. J Midwifery Womens Health 49:283–292

    Article  PubMed  Google Scholar 

  9. Rouse DJ, Owen J, Hauth JC (2000) Criteria for failed labor induction: prospective evaluation of a standardized protocol. Obstet Gynecol 96:671–677

    CAS  PubMed  Google Scholar 

  10. Chong YS, Su LL, Arulkumaran S (2004) Current strategies for the preventionof postpartum hemorrhage in the third stage of labor. Curr Opin Obstet Gynecol 16:143–150

    Article  PubMed  Google Scholar 

  11. Ying Gai Ming, Wu Lian-fang Su, Qi-feng Karin Tatsumoto (2004) Clinical observation of blood loss reduced by tranexamic acid during and after caesarian section: a multi-center, randomized trial. Eur J Obstet Gynecol Reprod Biol 112:154–157

    Article  Google Scholar 

  12. Carroli G, Cuesta C, Abalos E, Gulmezoglu AM (2008) Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol 22:999–1012

    Article  PubMed  Google Scholar 

  13. Cotter AM, Ness A, Tolosa JE (2001) Prophylactic oxytocin for the third stage of labour. Cochrane Database Syst Rev (4)

  14. Westhoff G, Cotter AM, Tolosa JE (2013) Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev 10:CD001808. doi:10.1002/14651858.CD001808.pub2

    PubMed  Google Scholar 

  15. Davies GA, Tessier JL, Woodman MC, Lipson A, Hahn PM (2011) Maternal hemodynamics after oxytocin bolus compared with infusion in the third stage of labor: a randomized controlled trial. Obstet Gynecol 105:294–299

    Article  Google Scholar 

  16. Soltani H, Hutchon DR, Poulose TA (2006) Timing of prophylactic uterotonics for the third stage of labour after vaginal birth. Cochrane Database Syst Rev (4)

  17. Jackson KW Jr, Allbert JR, Schemmer GK, Elliot M, Humphrey A, Taylor J (2001) A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage. Am J Obstet Gynecol 185:873–877

    CAS  Article  PubMed  Google Scholar 

  18. Breathnach F, Geary M (2006) Standard medical therapy. In: Blynch C, Keith LG, Lalonde AB, Karoshi M (eds) A textbook of postpartum haemorrhage. Sapiens Publishing, Duncow, pp 256–262

    Google Scholar 

  19. Charbit B, Funck-Brentano C, Samain E, Jannier-Guillou V, Albaladejo P, Marty J (2007) QT interval prolongation after oxytocin bolus during surgical induced abortion. Clin Pharmacol Ther 76:359–364

    Article  Google Scholar 

  20. Svanström MC, Biber B, Hanes M, Johansson G, Näslund U, Bålfors EM (2008) Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during caesarean section. Br J Anaesth 100:683–689

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

  1. Department of Obstetrics and Gynaecology, Bakirkoy Dr. Sadi Konuk Teaching and Research Hospital, Tevfik Saglam Street, No: 11, Zuhuratbaba, Bakirkoy, Istanbul, Turkey

    Hediye Dagdeviren, Huseyin Cengiz, Ulkar Heydarova, Sema Suzen Caypinar, Ammar Kanawati, Ender Guven & Murat Ekin

Authors
  1. Hediye Dagdeviren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Huseyin Cengiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ulkar Heydarova
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sema Suzen Caypinar
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ammar Kanawati
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ender Guven
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Murat Ekin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hediye Dagdeviren.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Dagdeviren, H., Cengiz, H., Heydarova, U. et al. Intramuscular versus intravenous prophylactic oxytocin for postpartum hemorrhage after vaginal delivery: a randomized controlled study. Arch Gynecol Obstet 294, 911–916 (2016). https://doi.org/10.1007/s00404-016-4060-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-016-4060-7

Keywords

  • Oxytocin
  • Postpartum haemorrhage
  • Randomized controlled trial
  • Vaginal delivery