Effect of the timing of Intramuscular Oxytocin injection on Maternal bleeding during the third stage of labour

The third stage of labour is one of the most troublesome stages of child delivery. The basic principle of the third stage management is administrating prophylactic uterotonics. However, the time of its administration varies in different hospitals. This study aimed to determine the effect of intramuscular oxytocin injection after emergence of the fetal anterior shoulder or placental expulsion on bleeding in the third stage of labour. This clinical trial was conducted on 100 pregnant women with gestational age of 38-42 weeks, and singleton pregnancies. Subjects were selected using convenience sampling and were then randomly assigned to intervention [injection of 10 IU intramuscular oxytocin after emergence of the fetal anterior shoulder] and control [injection of 10 IU intramuscular oxytocin after placental expulsion] groups. Blood was collected in containers and weighed with a weighing scale. A checklist was used to record labor and delivery related data. Data were analyzed by SPSS version 11.5, using Chi-square and t-test. The mean amount of bleeding during the third stage of labour was 183.4 +/- 145.8 and 202.2 +/- 208.8 ml in intervention and control group, respectively. No significant difference was found between two groups in terms of maternal bleeding. Injection of intramuscular oxytocin either after emergence of the fetal anterior shoulder or placental expulsion does not affect the amount of maternal bleeding during the third stage of labour

[Treatment of labial adhesion with topical estrogen and correlation with serum estradiol level]

Serum estradiol level is a controversial prognostic factor in the outcome of labial adhesion. The aim of this study was to evaluate serum estradiol levels and topical estrogen response in patients with labial adhesion. A prospective interventional study was conducted among girls with labial adhesion that referred to Pediatrics clinic in Taleghani University Hospital, Gorgan city, Iran in 2011. One hundred patients entered the study. The diagnosis was conducted by clinical examination of vestibule area. Inclusion criteria were, three months to eight years old prepuberty girls, no ambiguous genitalia, lack of vulvovaginitis symptoms, labial adhesion more than twenty five percent, no history of previous topical estrogen treatment since two weeks ago and previous incomplete treatment. The patients who did not use proper amount and duration of drug and also with adverse drug reactions during treatment period were excluded from the study. The maximum frequency of labial adhesion was in the group of less than one year old. The minimum frequency of labial adhesion was in the 7-8 years old group. Eighty six patients had complete or partial remission. No evidence of an improvement was observed in fourteen children. Severity of adhesions did not worsen in our patients. Serum estradiol levels were lower in patients who had a positive response to treatment. There were significant differences in serum estradiol levels between full or relative improvement with no improvement groups [P=0.044]. Findings of this study showed that the labial adhesion patients with low serum estradiol level had better treatment response after using topical estrogen.