Randomised controlled trial of oxytocin alone versus oxytocin and ergometrine in active management of third stage of labour.
OBJECTIVE
To compare intramuscular oxytocin alone and intramuscular oxytocin with ergometrine (Syntometrine) for their effect in reducing the risk of postpartum haemorrhage when both are used as part of the active management of the third stage of labour.


METHODS
Double blind, randomised controlled trial.


METHODS
Two metropolitan teaching hospitals in Perth, Western Australia.


METHODS
All women who expected a vaginal birth during the period of the trial. Informed consent was obtained.


METHODS
Postpartum haemorrhage, nausea, vomiting, and increased blood pressure.


RESULTS
3497 women were randomly allocated to receive oxytocin-ergometrine (n = 1730) or oxytocin (n = 1753). Rates of postpartum haemorrhage (> or = 500 ml or > or = 1000 ml) were similar in both arms (odds ratio 0.90 (0.82); 95% confidence interval 0.75 to 1.07 (0.59 to 1.14) at 500 ml (1000 ml) threshold). The use of oxytocin-ergometrine was associated with nausea, vomiting, and increased blood pressure.


CONCLUSIONS
There are few advantages but several disadvantages for the routine use of oxytoxinergometrine when prophylactic active management of the third stage of labour is practised. Further investigation of dose-response for oxytocin may be warranted.
McDonald
S J
SJ
King Edward Memorial Hospital for Women, Subiaco, Australia.
Prendiville
W J
WJ
Blair
E
E
D001794:Blood Pressure / Q000187:drug effects; D004338:Drug Combinations; D004874:Ergonovine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007273:Injections, Intramuscular; D007749:Labor Stage, Third; D009325:Nausea / Q000139:chemically induced; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D012307:Risk Factors; D014839:Vomiting / Q000139:chemically induced
D004338:Drug Combinations; D006454:Hemoglobins; D010121:Oxytocin; D004874:Ergonovine