ABSTRACT
Post partum hemorrhage as a consequence of uterine atony represents a leading of maternal morbidity and mortality. Prophylactic oxytocin, commonly administered after fetal or placental delivery, reduces the incidence of post partum hemorrhage by up to 40%. Evidence from studies suggests that giving oxytocin before rather than after placental expulsion, minimizes third - stage duration and blood loss. The general obiective was to compare oxytocin administration before and after placental delivery in the prevention of post partum hemorrhage. This research was a prospective randomized clinical trial study, parturients who presented for vaginal delivery were randomized to receive oxytocin, 20 units in a 500 ml serum Ringer, beginning upon delivery of either the fetal anterior shoulder or placenta. For all patients, the third stage of labor was similar. Patients were excluded if they had a pervious ceasarean section, multiple gestation, an tepartum hemorrhage, or bleeding disorder. A total 70 patients were enrolled: 35 in the before placenta group and 35 in the after placenta group. The groups were similar with respect to gestational age, maternal age, fetal weight, Labor duration, parity and pervious postpartum hemorrhage. The incidence of post partum hemorrhage were significantly between the two groups [91 +/- 22 ml VS 127 +/- 50 ml]. There were significant differences between two groups in third stage duration [4 +/- 2 min VS 7 +/- 1 min], but there were no significant differences between the two groups with no incidence of retained placenta. The administration of prophylactic oxytocin before placental delivery significantly reduces the incidence of postpartum hemorrhage or third stage duration when compared with oxytocin after placental delivery