A randomised controlled study for the prevention of post-partum haemorrhage with oxytocin plus methyl ergometrine versus oxytocin alone in the third stage of labour

Authors

  • Rajani Somanathan Department of Obstetrics and Gynaecology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India http://orcid.org/0000-0002-9259-9879
  • Mohanapriya Balu Department of Obstetrics and Gynaecology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India Department of Obstetrics and Gynaecology, Sri Ramakrishna Hospital, Coimbatore, Tamil Nadu, India
  • Elizabeth Jacob Department of Obstetrics and Gynaecology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India
  • Sr Marykutty Illickal Department of Obstetrics and Gynaecology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20211509

Keywords:

Post-partum haemorrhage, PPH, Oxytocin, Methyl ergometrine

Abstract

Background: Postpartum haemorrhage is the leading cause of maternal death. Uterine atony which is preventable, causes 80% of Post partum haemorrhage (PPH). Active management of third stage of labour (AMTSL) lowers maternal blood loss and reduces the risk of PPH. In this open labelled randomised controlled study we compared the combined use of oxytocin and methyl ergometrine vs oxytocin alone in prevention of PPH in the third stage of labour.

Methods: 200 Women admitted for safe confinement and following the inclusion criteria were randomised immediately post delivery to receive either oxytocin +methyl ergometrine or oxytocin alone. The amount of blood loss was assessed objectively by weighing the mops and under sheets used during delivery. If bleeding could not be controlled, additional uterotonics were given. The incidence of PPH, amount of blood loss, use of additional uterotonics and side effects were recorded. The difference in pre natal and post natal haemoglobin (Hb) and the need for blood transfusion were assessed.

Results: There was no statistically significant difference in the incidence of PPH between the groups. Post partum blood loss was significantly lesser in the combined group. Additional oxytocics were required more often in the oxytocin only group. The incidence of headache was significantly more in the combined group. The difference in haemoglobin levels post natally and the need for blood transfusion was comparable among both groups.

Conclusions: The combined use of methyl ergometrine +oxytocin is not recommended over oxytocin alone in the third stage of labour for prevention of PPH.

Author Biography

Rajani Somanathan, Department of Obstetrics and Gynaecology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India

consultant

Department of obstetrics and gynaecology

Little flower Hospital, Angamaly

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Published

2021-04-23

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Original Research Articles