The effect of intraumbilical oxytocin on the third stage of labour. A randomized comparison of umbilical vein and intravenous oxytocin during the puerperium. Effect of umbilical vein oxytocin injection on the third stage of labor: a randomized controlled study. [Oxitocin trough umbilical vein to shorten the third stage of labor]. The effect of intraumbilical oxytocin on the third stage of labor. Influence of umbilical vein administration of oxytocin on the third stage of labor: a randomized, double-blind, placebo-controlled study. Intraumbilical veinous injection oxytocin in the active management of third stage of labour.
The umbilical vein administration of oxytocin in saline was compared with umbilical vein saline alone and the traditional management of the third stage of labour. Seventy-two women were randomized to 3 groups. Group 1 received intraumbilical 20 IU of oxytocin diluted to 40 mL with saline. Group 2 received intraumbilical vein 40 mL of saline while subjects in group 3 were managed according to the standard protocol without any intraumbilical injection. No significant differences were found in terms of the length of the third stage, the blood loss in the third stage and postpartum haematocrit differences among the 3 groups. The administration of diluted oxytocin or saline do not seem to have any superiority to the traditional management of the third stage of labour. Oxytocin was administered in a randomized fashion via either the umbilical or maternal intravenous route. Women who received intraumbilical oxytocin had significantly greater calculated blood loss compared with those who received peripheral administration (P = .01). This greater blood loss was confirmed by a decrease in hematocrit and hemoglobin concentrations after delivery. There was no difference between the groups in the length of the third stage of labor. The incidence of fetomaternal transfusion was higher in the intraumbilical group (P = .07). We conclude that intraumbilical oxytocin is no more beneficial than peripheral administration. To evaluate the effect of umbilical vein oxytocin injection on the duration of third stage of labor, and estimated blood loss within 24 hours postpartum, in 50 vaginal parturients at Rajavithi Hospital from March 1, 1994 and June 30, 1995. The parturients were randomized to administered either an umbilical vein injection of 20 units of oxytocin diluted to 20 ml with normal saline (oxytocin group) or only normal saline 20 ml (control group) immediately after cord clamping. There were 25 paturients in each group. The duration of the third stage of labor in the oxytocin group was significantly shorter than that in the control group. In only 1 case of the control group was manual placental removal performed. The estimated blood loss within 24 hours postpartum in both groups was not statistically different. Twenty units of umbilical vein oxytocin injection was effective to shorten the duration of the third stage of labor but were not effective to reduce the estimated blood loss within 24 hours postpartum. The need for a further large scale study in the future was suggested. To examine the efficacy and safety of oxitocin administered through umbilical vein after delivery to diminish the incidence of retained placenta, blood loss and third stage of labour.
                A double blind, clinical trial was performed in which 64 women in labour, any age, with normal pregnancies, with gestational time between 37 to 42 weeks, were randomized to one of two groups. Group 1 received 10 UI of oxitocin (2 mL) diluted in 18 mL of saline solution through umbilical vein, immediately after delivery. Group 2 received only 20 mL of saline solution. Blood loss, time of third stage of labour, retained placenta, nausea, vomit and arterial hypotension were measured.
                Blood loss was 263.7 +/- 220.9 mL in group 1 (n=32) and 286.7 + 230.4 in group 2 (n=32) (p=0.68, Student T test). Time of third stage of labour was 265.3 +/- 383.9 seconds in group 1 and 197.1 +/- 314.3 in group 2 (p=0.44, Student T test). There was one retained placenta in group 1 and two in group 2 (RR 0.5 IC 0.04 a 5.24). There were not side effects in any group.
                Oxitocin trough umbilical vein immediately after delivery was not useful to diminish blood loss, retained placenta or time of third stage of labour. To determine whether intraumbilical oxytocin would shorten the third stage of labor, we enrolled 50 normal parturients into a randomized, double-blind protocol. Either 10 U of oxytocin diluted to 20 mL in normal saline (25 subjects) or 20 mL of normal saline alone (25 subjects) was injected into the placental circulation within one minute after cord clamping. The mean (+/- SD) duration of the third stage was 4.1 +/- 2.0 minutes in saline-treated subjects and 4.6 +/- 3.4 minutes in those treated with oxytocin. Intraumbilical oxytocin was not effective in shortening the normal third stage of labor. A randomized, double-blind, placebo-controlled study evaluated the influence of umbilical vein administration of oxytocin on the third stage of labor. Five minutes after delivery, 37 women received 10 units of oxytocin diluted in physiologic saline solution to a total volume of 20 ml; 41 women received 20 ml of saline solution alone. There was no significant difference between groups in mean (+/- SD) injection-placental expulsion interval (9 +/- 7 versus 10 +/- 8 minutes). To determine the role of intraumbilical vein oxytocin reducing blood loss during and after one hour of delivery of placenta and its efficacy in reducing the frequency of retained placenta.
                Randomized controlled trial.
                Combined Military Hospital, Multan, from June 2002 to October 2002.
                Five hundred parturient women with low risk singleton term pregnancy were enrolled in the study. Two hundred and fifty women each were included in the study and control group after randomization. The patients and health care providers both were blinded to the intervention. Primary outcome measures were kept as duration and amount of blood loss in third stage of labour. Secondary outcome measures included incidence of retained placenta, abdominal need for additional utero-tonics, frequency of postpartum pain, nausea and vomiting, fever, need for blood transfusion, establishment of breast feeding and total duration of hospital stay.
                Women in study group who received intraumbilical vein syntocinon lost 234.03 ml of blood while the control group lost 276.51 ml (p=0.001). Mean duration of third stage was 2.59 minutes in the study group and 7.67 minutes in the control group (p<0.001). The frequency of retained placenta was 1.2%, which involved only the control group. Abdominal pain was experienced by study group but the difference was not found statistically significant. Nausea and vomiting was more in study group (p=0.001). No discernible difference was found in length of hospital stay, the need for blood transfusion, fever and establishment of breast-feeding in both groups.
                The addition of intraumbilical vein syntocinon 10 units resulted in marked reduction in amount of blood loss, duration of third stage and incidence of retained placenta in comparison to intravenous 5 IU oxytocin+0.5 mg ergometrine alone.
Routine use of oxytocin or any other uterotonics with normal saline via umbilical vein injection is not recommended until new evidence is available. Further research should be conducted to show effectiveness of oxytocin with normal saline via umbilical vein injection.