Effect of Active Management of the Third Stage of Labor with Intramuscular Oxytocin Injection on Postpartum Hemorrhage at Nopparat Rajathanee Hospital

Abstract

          The objective of this randomized clinical controlled trial research was to compare the effect of active management with intramuscular oxytocin injection versus expectant management of the third stage of labor on blood loss, postpartum hemorrhage and maternal complications at Nopparat Rajathanee Hospital, Bangkok. Prospective data of women having singleton vaginal births in January - April, 2009 at Nopparat Rajathanee Hospital were collected. Estimated blood losses were compared between women received active management in the third stage of labor (65 cases) versus expectant management (65 cases). The other outcomes included duration of the third stage of labor and maternal complications. The active management of the third stage of labor resulting in less postpartum maternal blood loss was observed. Moreover, shorter third stage of labor time and significantly less frequent side effects of uterotonics were reported in the active management group. These study findings suggest that active management of the third stage is as effective in reducing maternal blood loss in Nopparat Rajathanee Hospital as reported in other randomized trials in large institutions. This practice is also feasible and useful in preventing postpartum hemorrhage and should be performed in all cases of patients.
Key words: active management, third stage of labor, postpartum hemorrhage