title: Using Uniject to increase the use of prophylactic oxytocin for management of the third stage of labor in Latin America.
abstract: OBJECTIVE
  To evaluate a multifaceted intervention for effectiveness in increasing the use of prophylactic oxytocin by birth attendants (obstetricians, midwives, and nurses) working in small maternity hospitals in Argentina.
  
  
  METHODS
  A before-and-after quasi-experimental study was conducted in 5 small maternity hospitals. The study intervention consisted of training birth attendants in the active management of the third stage of labor, distributing oxytocin in Uniject (Hipofisina BIOL Uniject; Laboratorios BIOL, Buenos Aires, Argentina), and using posters as reminders. The primary outcome was the rate of prophylactic oxytocin use in the 6 months before and the 6 months of the intervention period. Secondary outcomes included use of controlled cord traction and uterine massage, and birth attendants' acceptance of the use of oxytocin in Uniject.
  
  
  RESULTS
  The use of prophylactic oxytocin showed a median rate of 14.6% at baseline and 85.6% during the intervention period. 96% of birth attendants reported that the Uniject device facilitated oxytocin 1 administration.
  
  
  CONCLUSIONS
  Prophylactic oxytocin in the third stage of labor is a beneficial intervention with current low use, particularly in low- and middle-income countries. If the results shown in the present study were further replicated, this strategy could be an effective method for improving prophylactic oxytocin use in other similar Latin American hospitals.
authors.affiliation: Institute for Clinical Effectiveness and Health Policy, IECS, Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Althabe
authors.forename: Agustina
authors.initials: A
authors.lastname: Mazzoni
authors.forename: María L
authors.initials: ML
authors.lastname: Cafferata
authors.forename: Luz
authors.initials: L
authors.lastname: Gibbons
authors.forename: Ariel
authors.initials: A
authors.lastname: Karolinski
authors.forename: Deborah
authors.initials: D
authors.lastname: Armbruster
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.forename: José M
authors.initials: JM
authors.lastname: Belizán
mesh_terms: D000293:Adolescent; D000328:Adult; D001118:Argentina; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007267:Injections / Q000295:instrumentation; D007749:Labor Stage, Third; D008880:Midwifery / Q000193:education; D010121:Oxytocin / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D055815:Young Adult
chemical_list: D010121:Oxytocin