A randomized comparison of oxytocin, sulprostone and placebo in the management of the third stage of labour

Abstract

Objective— To compare the effect on post partum bloodloss of the postpartum prophylactic administration of oxytocin or sulprostone in low risk women having an expectant management of the third stage. Design— Randomized, placebo controlled, double-blind trial. Setting— Radboud University Hospital, Nijmegen (67 women) and Lievensberg Hospital, Bergen op Zoom (10 women). Participants— 77 women entered the trial (three were excluded). Interventions— The intramuscular injection, immediately after the birth of the baby, of either oxytocin 5 IU, sulprostone 500 ng or 0.9% saline. Main outcome measures— Quantitative postpartum blood loss and length of third stage. Results— Postpartum blood loss was reduced almost equally, by about 35%, by oxytocin (P = 0.02), or sulprostone (P = 0.05). The mean length of the third stage was shorter in both groups receiving the active treatment, this effect was significant in the sulprostone group (P = 0.01). Conclusion— Prophylactic administration of oxytocin or sulprostone directly after delivery followed by expectant management of the third stage reduces post partum blood loss and shortens the third stage.