Active Management of Third Stage of Labor: A Comparison of Various Uterotonic

Abstract

ABSTRACT Aims and objectives This study was aimed at comparing the various uterotonics in active management of third stage of labor and reducing blood loss. Materials and methods A prospective study was conducted in the Department of Obstetrics and Gynecology of SRMSIMS, Bareilly, in 100 women. Patients were randomized into four groups of 25 each and were given oxytocic within 1 minute of delivery of the baby. Oxytocics used were 10 IU intramuscular oxytocin, 0.2 mg intravenous methylergometrine, 125 μg intramuscular 15-methyl PGF2-alpha and 600 μg tablet misoprostol per rectally in groups A, B, C and D respectively. Results Duration of third stage of labor recorded was minimum with methergine with mean duration of 3.84 ± 0.99 minutes and was maximum with prostodin with mean duration of 5.04 ± 1.02 minutes. Amount of blood loss observed was minimum with methergine (mean 131 ± 72.037 ml) and maximum with Prostodin (mean 435 ± 147.578 ml). Hemoglobin drop was also seen maximally with prostodin with mean drop of 0.872 ± 0.458 gm% and minimally with methergine with mean drop of 0.236 ± 0.221 gm%. Change in the general condition of the patients in the form of tachycardia, fall in systolic and diastolic blood pressure was observed maximum with prostodin group whereas, in other groups, there was no significant change. Conclusion It is concluded from this study that methergine is the uterotonic of choice followed by oxytocin for active management of third stage of labor. How to cite this article Modi V, Goel JK, Kashyap A, Arya SB, Kar J, Goel R. Active Management of Third Stage of Labor: A Comparison of Various Uterotonic. J South Asian Feder Obst Gynae 2014;6(3):151-155.