A RANDOMIZED COMPARISON OF OXYTOCIN, SULPROSTONE AND PLACEBO IN THE MANAGEMENT OF THE 3RD STAGE OF LABOR

Objective-To compare the effect on post partum bloodloss of the postpartum prophylactic administration of oxytocin or sulprostone in low risk women having an expectant management of the third stage. Design-Randomized, placebo controlled, double-blind trial. Setting-Radboud University Hospital, Nijmegen (67 women) and Lievensberg Hospital, Bergen op Zoom (10 women). Participants-77 women entered the trial (three were excluded). Interventions-The intramuscular injection, immediately after the birth of the baby, of either oxytocin 5 IU, sulprostone 500-mu-g or 0.9% saline. Main outcome measures-Quantitative postpartum blood loss and length of third stage. Results-Postpartum blood loss was reduced almost equally, by about 35%, by oxytocin (P = 0.02), or sulprostone (P = 0.05). The mean length of the third stage was shorter in both groups receiving the active treatment, this effect was significant in the sulprostone group (P = 0.01). Conclusion-Prophylactic administration of oxytocin or sulprostone directly after delivery followed by expectant management of the third stage reduces post partum blood loss and shortens the third stage.