Effect of Diluted Intraumbilical Administeration of Oxytocin on the Third Stage of Labor: A Randomized Clinical Trial

摘要

BackgroundandObjective:Postpartumhemorrhageisanimportantcauseofmaternalmorbidityandmortality.Activemanagementofthirdstageoflaborincludingtheuseofuterotonicagentscouldbeeffectiveinreductionofpostpartumhemorrhageandperipartummortalityandmorbidity.Thisstudyaimedtocomparetheefficacyofintraumbilicalinjectionofdilutedoxytocinwithintravenousinfusionofoxytocinintheactivemanagementofthirdstageoflabor.SubjectsandMethods:Thisrandomizedclinicaltrialwasdoneon102vaginaldeliveryprimiparouspregnantwomen.Womeninfirstgroup(n=51)received20unitsofdilutedoxytocinin20mlof0.9%N/Sinjectedintheumbilicalvein.Womeninsecondgroup(n=51)received20unitsofdilutedoxytocinintra-venously.Theprimaryoutcomemeasurementwasthemeandurationofthirdstageoflaborandmeanchangesinpost-deliveryhemoglobin.DatawereanalyzedusingSPSSVer.15.0,descriptivestatistics,ttestandChisquarewith95%ofconfidenceinterval.Results:Meandurationofthirdstageoflaborinintraumbilicalgroup(3.50±0.97min)wassignificantlyshorterthanintravenousgroup(5.16±1.13min)(P=0.001).Alsowomeninintravenousgrouphadloweramountofpost-deliveryhemoglobin(9.66±0.91g/dl)thanwomeninintraumbilicalgroup(10.42±0.70g/dl)(P=0.001).Conclusion:Itseemsthatactivemanagementofthethirdstageoflaborusingintraumbilicaloxytocincomparedwithintravenousinfusionofoxytocincanreducethelengthofthirdstageoflaborand,afterdelivery,lessinhemoglobinlevel.