Effect of Diluted Intraumbilical Administeration of Oxytocin on the Third Stage of Labor: A Randomized Clinical Trial

Postpartum hemorrhage is an important cause of maternal morbidity and mortality. Active management of third stage of labor including the use of uterotonic agents could be effective in reduction of postpartum hemorrhage and peripartum mortality and morbidity. This study aimed to compare the efficacy of intraumbilical injection of diluted oxytocin with intravenous infusion of oxytocin in the active management of third stage of labor. Subjects and This randomized clinical trial was done on 102 vaginal delivery primiparous pregnant women. Women in first group (n=51) received 20 units of diluted oxytocin in 20 ml of 0. 9% N/S injected in the umbilical vein. Women in second group (n=51) received 20 units of diluted oxytocin intra-venously. The primary outcome measurement was the mean duration of third stage of labor and mean changes in post-delivery hemoglobin. Data were analyzed using SPSS Ver. 15. 0، descriptive statistics، t test and Chi square with 95% of confidence interval. Mean duration of third stage of labor in intraumbilical group (3. 50±0. 97 min) was significantly shorter than intravenous group (5. 16±1. 13 min) (P=0. 001). Also women in intravenous group had lower amount of post-delivery hemoglobin (9. 66±0. 91 g/dl) than women in intraumbilical group (10. 42±0. 70 g/dl) (P=0. 001). It seems that active management of the third stage of labor using intraumbilical oxytocin compared with intravenous infusion of oxytocin can reduce the length of third stage of labor and، after delivery، less in hemoglobin level.