[Comparison of intramuscular syntometrine and intravenous oxytocin in management of the third stage of labor]

ABSTRACT

One of the main etiologies of maternal mortality is obstetrical hemorrhage. The first step in decreasing hemorrhage is the use of uterotonic drugs in the third stage of labor. To compare the efficacy and safety of intravenous oxytocin and intramuscular syntometrine in management of the third stage of labor. This randomized double blind clinical trial was carried out at Kosar Hospital, Qazvin [Iran] in 2005. A total of 800 women having a singleton pregnancy and vaginal delivery were randomized to receive either 1 ml of syntometrine intramuscularly, or 10 units of intravenous oxytocine following delivery of the anterior shoulder of fetus. Hemoglobin level pre- and 24 hours post-delivery, duration of third stage, need for re-administration of uterotonic drugs, need for manual removal of placenta, and unpleasant side effects including nausea, vomiting, headache and hypertension were recorded. The data were analyzed using chi-square test. Mean drop percent of hemoglobin level in oxytocin group was 3.7 +/- 2.54% and in syntometrine group 3.6+2.49% with no significant difference, statistically. There was also no statistically significant difference between the need for re-administration of uterotonic drugs, duration of third stage of labor, need for manual removal of placenta and the maternal side effect in two groups. Regarding the efficacy and side effects of intravenous oxytocin and intramuscular syntometrine, no difference was found