title: Prospective randomized trial of oxytocin administration for active management of the third stage of labor.
abstract: OBJECTIVE
  To determine the most efficient route and timing of oxytocin administration for active management of the third stage of labor.
  
  
  METHODS
  A prospective randomized study was done at one center in Ankara, Turkey, between January and October 2010. Women with a singleton pregnancy (>37 weeks) who had a live vaginal birth were randomly allocated to four groups: iv-A (intravenous oxytocin after delivery of the fetus), iv-B (when anterior shoulder seen), im-A (intramuscular oxytocin after delivery), and im-B (when anterior shoulder seen). Postpartum blood loss within the first hour, hemoglobin, hematocrit, and duration of the third stage were compared.
  
  
  RESULTS
  A total of 600 eligible women were recruited; 150 were assigned to each group. Postpartum blood loss, prepartum and postpartum hemoglobin and hematocrit, and need for additional uterotonics were similar among groups (P>0.05). The duration of the third stage of labor and changes in hemoglobin and hematocrit were significantly reduced in group iv-B (P<0.05). Among women not exposed to oxytocin before delivery, postpartum blood loss was significantly lower in group iv-B (P=0.019). Labor augmentation was related to significantly increased postpartum blood loss in all groups except iv-A.
  
  
  CONCLUSIONS
  Although postpartum blood loss was similar in all groups, early intravenous administration seemed to have beneficial effects. ClinicalTrials.gov: NCT01954186.
authors.affiliation: Sivas State Hospital, Sivas, Turkey.
authors.forename: Emire
authors.initials: E
authors.lastname: Oguz Orhan
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey. Electronic address: sdilbaz@hotmail.com.
authors.forename: Berna
authors.initials: B
authors.lastname: Dilbaz
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Teaching and Research Hospital, Ankara, Turkey.
authors.forename: Sezin Erturk
authors.initials: SE
authors.lastname: Aksakal
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University Kastamonu Medical Faculty, Ankara, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Altınbas
authors.affiliation: Department of Obstetrics and Gynecology, Zekai Tahir Burak Maternity and Teaching Hospital, Ankara, Turkey.
authors.forename: Salim
authors.initials: S
authors.lastname: Erkaya
mesh_terms: D000328:Adult; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007749:Labor Stage, Third; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D010120:Oxytocics; D010121:Oxytocin
keywords: Active management of third stage of labor; Labor augmentation; Oxytocin; Postpartum hemorrhage