Abstract
BackgroundThis study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, and anemia after delivery.MethodsIn this study, 108 women were randomly assigned to two groups of breast pump stimulation (n = 54) and oxytocin administration (n = 54). Women in the breast stimulation group received breast pump stimulation (10 min intermittently for each breast with a negative pressure of 250 mmHg), while the women in the oxytocin (control) group received an infusion of 30 IU oxytocin in 1000 mL of Ringer’s serum with a maximum rate of 10 mL infusion per min after delivery. The duration of the third stage of labor, blood loss during the third stage of labor and 24 h after delivery, hemoglobin and hematocrit (before and 24 h after delivery), after-birth pain, and the number of breastfeedings during the 24 h after delivery were recorded. The data were analyzed using the chi-square test, independent t-test, and Wilcoxon test.ResultsThe mean duration of the third stage was 5 ± 1.97 and 5.4 ± 2.5 min in the breast stimulation and women that received intravenous oxytocin respectively (p = 0.75). Most participants had mild postpartum hemorrhage (98.1 and 96.2% in the breast stimulation and women that received intravenous oxytocin, respectively, p = 0.99). Although hemoglobin and hematocrit levels significantly decreased in both groups 24 h after delivery, there was no significant difference between both groups regarding both parameters. After-birth pain was significantly lower and the number of breastfeeding during the 24 h after delivery was significantly more in the breast stimulation group compared to the control group.ConclusionsOur results demonstrated no differences between breast pump stimulation and oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, anaemia, after-birth pain, and the number of breastfeedings during the 24 h after delivery.Trial registration numberThe study protocol was registered in the Iranian Randomized Controlled Trial Registry (Ref. No.: IRCT2015050722146N1; Registration date: 2015–11-04). The study was registered prospectively and the enrollment date was 23/8/2015.
Highlights
This study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, and anemia after delivery
This study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the length of the third stage of labor, Postpartum Hemorrhage (PPH), and anemia
This study revealed that the number of women with moderate bleeding (500–1000 mL) in the control group was almost twice that in the breast stimulation group; the two groups did not show any significant difference regarding bleeding in the third stage of labor
Summary
This study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, and anemia after delivery. Prendiville et al, in a systematic review including five studies, showed that while active management of the third stage of labor, compared to expectant management, could reduce PPH exceeding 500 mL, maternal blood loss, and prolonged third stage of labor, it could cause maternal nausea, vomiting, and increased blood pressure [6]. Some maternal complications associated with the administration of oxytocin include nausea, vomiting, increased blood pressure, and adverse cardiovascular response [8]. Water intoxication is another side effect of oxytocin, especially when it administered continuously by infusion [9]
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