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Vol. 58, No. 2, 2004
Issue release date: August 2004
Section title: Original Article
Gynecol Obstet Invest 2004;58:72–76
(DOI:10.1159/000078095)

A Double-Blinded, Randomized Controlled Trial of Oxytocin at the Beginning versus the End of the Third Stage of Labor for Prevention of Postpartum Hemorrhage

Huh W.K. · Chelmow D. · Malone F.D.
Divisions of Maternal-Fetal Medicine and General Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Tufts University School of Medicine/Tufts-New England Medical Center, Boston, Mass., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 2/16/2004
Accepted: 5/8/2004
Published online: 8/13/2004

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI

Abstract

Objective: The objective of this study was to compare the administration of oxytocin at the beginning and end of the third stage of labor for the prevention of postpartum hemorrhage. Methods: Patients with documented singleton pregnancies were randomly assigned to two groups. The first received 10 units of oxytocin intramuscularly at delivery of the anterior shoulder of the fetus and an identical appearing placebo injection following delivery of the placenta. The second received the opposite medication sequence. The study was double blinded. Blood loss was measured by weighing all fluids collected, visual estimation, and serial blood counts. Results: 27 women received oxytocin at the delivery of the fetal shoulder and 24 after the placenta. Oxytocin given after placenta delivery resulted in lower blood loss (345 vs. 400 ml, p = 0.28), lower collection bag weight (763 vs. 833 g, p = 0.55), lower change in HgB (–1.26 vs. –1.32 g, p = 0.86), lower ΔHCT (–3.43 vs. –3.64%, p = 0.85), and a shorter third stage of labor duration (8.6 vs. 9.2 min, p = 0.75). The incidence of postpartum hemorrhage, defined as estimated blood loss >500 ml (0 vs. 14.8%) was significantly lowered with oxytocin following placental delivery (p = 0.049). Conclusions: In our study, postpartum hemorrhage was less frequent when oxytocin administration was delayed until after placenta delivery.


  

Author Contacts

David Chelmow, MD
Department of Obstetrics and Gynecology
Tufts-New England Medical Center
750 Washington St, Box 22, Boston, MA 02111 (USA)
Tel. +1 617 636 5980, Fax +1 617 636 8315, E-Mail dchelmow@tufts-nemc.org

  

Article Information

Received: May 8, 2003
Accepted after revision: February 16, 2004
Published online: April 20, 2004
Number of Print Pages : 5
Number of Figures : 0, Number of Tables : 2, Number of References : 6

  

Publication Details

Gynecologic and Obstetric Investigation
Founded 1895 as ‘Monatsschrift für Geburtshilfe und Gynäkologie’, continued 1946–1969 as ‘Gynaecologia’ and 1970 –1977 as ‘Gynecologic Investigation’

Vol. 58, No. 2, Year 2004 (Cover Date: Released August 2004)

Journal Editor: T.M. D'Hooghe, Leuven; J. Yankowitz, Iowa City, Iowa
ISSN: 0378–7346 (print), 1423–002X (Online)

For additional information: http://www.karger.com/journals/goi


Article / Publication Details

First-Page Preview
Abstract of Original Article

Received: 2/16/2004
Accepted: 5/8/2004
Published online: 8/13/2004

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 0378-7346 (Print)
eISSN: 1423-002X (Online)

For additional information: http://www.karger.com/GOI


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