A Comparative study of various uterotonics in active management of third stage of labour

Chawla D; Khatri R; Khatuja R; Gupta V; Agrawal R

Volume : VII, Issue : IV, April - 2018

A Comparative study of various uterotonics in active management of third stage of labour

Chawla D, Khatri R, Khatuja R, Gupta V, Agrawal R

Abstract :

Post partum hemorrhage is the second most common cause of maternal mortality. Routine active management of third stage of labor has definitive role in reducing maternal mortality and morbidity due to PPH. It includes administration of uterotonics, uterine massage and controlled cord traction in third stage of labour. Various uterotonics used are oxytocin, methyl ergometrine, 15 methyl prostaglandin F2α and misoprostol. Objective of our study was to know the efficacy and side effects of these agents in active management of third stage of labour. Material and methods – A total of 300 patients more than 37 weeks of gestation in active labour were enrolled after informed consent and clearance from ethical committee. They were divided into three groups Group O(N=100) received intramuscular oxytocin (10IU) Group M(N=100) received I ml intramuscular 0.2 mg methyl ergometrine, and Group P(N=100) received 1 ml intramuscular 250 mcg 15– methyl prostaglandin F2 alpha at the time of delivery of anterior shoulder of baby. Observation & Results : Intramuscular oxytocin is safest and most effective prophylactic uterotonic agent. It is associated with significantly lesser third stage blood loss, shorter duration of third stage, no significant fall in postpartum haemoglobin and minimum adverse effects, as compared to methylergometine and prostaglandins. There is no evidence to support for the use of ergot alkaloids in active management of third stage of labour. Prostaglandins has the disadvantage of significant increase in side effects.