IJCRR - 7(8), April, 2015
Pages: 19-22
COMPARATIVE EFFICACY OF SYNTOMETRINE VERSUS OXYTOCIN IN ACTIVE MANAGEMENT
OF THIRD STAGE OF LABOUR
Author: Arunadevi V.
Category: Healthcare
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Abstract:
Objective:
Postpartum hemorrhage is a major obstetrical complication and one of the important but preventable causes of maternal morbidity and mortality. The aim of the study is to compare the efficacy of syntometrine versus oxytocin in the active management of third stage of labor in reducing the risk of PPH and other adverse third stage outcomes.
Methodology:
This is a randomized prospective comparative study conducted from September 2008 to August 2009 at the department of Obstetrics and Gynecology, Institute of Social Obstetrics and Govt. Kasturba Gandhi Hospital for Women and Children, Chennai, on 300 patients. The patients were assigned to 2 groups at random of 150 patients in each group. All pregnant
women with singleton pregnancy of 20-35 years of age with no known risk factor for PPH were included. Exclusion criteria observed for patients with previous caesarean section, previous scarred uterus, multiple pregnancy, Cardiac patient, hepatic disorders, disorders of blood coagulation. The data was analyzed using t test and chi square test.
Results: The mean blood loss in syntometrine group was 120ml and oxytocin group was 171ml. The difference of mean blood loss between two group was 51ml, which is statistically significant (p=0.000).
Conclusion: It is concluded from this study that the use of syntometrine as part of routine AMTSL (Active Management of Third Stage of Labor) appears to be associated with a statistically significant reduction in mean blood loss when compared to Oxytocin.
Keywords: Syntometrine, Oxytocin, Third stage of labor, Postpartum hemorrhage
Citation:
Arunadevi V.. COMPARATIVE EFFICACY OF SYNTOMETRINE VERSUS OXYTOCIN IN ACTIVE MANAGEMENT
OF THIRD STAGE OF LABOUR International Journal of Current Research and Review. 7(8), April, 19-22
References:
1. Thilaganathan B et al, Management of the third stage of labour in women at low risk of postpartum hemorrhage. Eur J. Obstet Gynecol Reprod Biol. 1993. Jan: 48 (1): 19 –22.
2. Carroli G, Cuesta C, Abalos E, et al. Epidemiology of postpartum haemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol 2008; 22: 999–1012.
3. Mousa H, Alffirevic Z. Treatment for primary PPH (Cochrane Review). The Cochrane Library, Vol. I. Oxford : Update software;2003.
4. Abouzahr C. Global burden of maternal death and disability. Br Med Bull. 2003;67: 1–11.
5. Pritchard JA, Baldwin RM, Dickey JC, Wiggins KM. Blood volume changes in pregnancy and puerperium. Am J Obstet Gynecol 1962; 84 (10); 1271–82.
6. Coombs CA, Murphy EL, Laros RK. Factors associated with postpartum hemorrhage with vaginal birth. Obstet Gynecol 1991; 69–76.
7. Prevention and management of postpartum hemorrhage; Royal College of Obstetricians and Gynaecologists (May 2009 with revision April 2011).
8. Fullerton G, Danielian PJ, Bhattacharya S: Outcomes of pregnancy following postpartum haemorrhage. BJOG. 2013 Apr 120 (5); 621–7.
9. Carroli G, Cuesta C, Abalos E, et al: Epidemiology of postpartum heamorrhage a systematic review. Best Pract Research Clinic Obstet Gynaecol. 2008 Dec; 22 (6); 999– 1012.
10. Schuurmans N. Mackinnon C, Lane C, Etches D. Prevention and Management of postpartum Hemorrhage. SOGCC. Clinical Practice Guidelines. No.88, April 2000.
11. Prevention and treatment of post partum haemorrhage : new advances for low resources settings. Joint – Statement. International Confederation of Midwives (ICM) International Federation of Gynaecology and Obstetrics (FIGO).
12. Prendiville WJP, Elbourne D, McDonald SJ. Active versus expectant management in the third stage of labour. Cochrane Database of Systematic Reviews 2009; Issue 3.
13. WHO recommendations for the prevention of postpartum haemorrhage. Geneva: World Health Organization; 2007.
14. Hozerzeil HV, Walker GJA and De Goeje MJ (1994) Oxytocin is more stable in tropical countries.
15. Chua, S. Arul Kumaran, S. Adaikan, G. et al., (1993). The effect of oxytocin stored at high temperatures on postpartum uterine activity. Br. J. Obstet, Gynaecol, 100,874–875.
16. McDonald S, Prendville WJ, Elbourne D, Prophylactic syntometrine versus oxytocin for delivery of the placenta. The Cochrane Database of Systematic reviews, Volume 1, 2001.
17. Docherty PW, Hooper M, Choice of an oxytocic agent for routine at delivery. J Obstet Gynaecol 1981; 2: 60.
18. Yuen PM, Chan NST, Yim SF, Chang AMZ,. A randomized double blind comparison of syntometrine and syntocinon in the management of third stage of labor. Br. J Obstet and Gynaecol 1995; 102377–380.
19. Ebardo Abalos. Evidence summary, Different interventions have been proposed for the management of third stage of labour. RHL. 20. Dwyer N (1994) Nausea is a fair price for preventing hemorrhage Br. Med J 308, 59.
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