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 micrograms 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.