Third stage of labor assisted with intraumbilical oxytocin: expectant and routinary

Authors

  • Rosa Gutarra Vilchez Médico Gineco-Obstetra, Asistente, Hospital de Vitarte, Lima, Perú. PhDc de Pediatría, Obstetricia y Ginecología, Medicina Preventiva y Salud Pública de la Universidad Autónoma de Barcelona, España.
  • Teodardo Campos Solórzano Médico Gineco-Obstetra, Asistente, Hospital Nacional Daniel Alcides Carrión, Lima, Perú. MDc en Gestión Estratégica de la Calidad y Auditoría Médica de la Universidad Particular San Martín de Porras.
  • Frine Samalvides Cuba Médico Infectólogo, Asistente, Hospital Nacional Cayetano Heredia, Lima, Perú. Profesor Asociado, Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia.

DOI:

https://doi.org/10.31403/rpgo.v58i45

Abstract

Objectives: To determine efficacy and safety of assisted third stage of labor using intraumbilical oxytocin or either expectant or routinary. Design: Clinical controlled trial. Location: Hospital Vitarte, Ministerio de Salud, Lima Peru. Participants: Women in third stage of labor. Interventions: One hundred and eighty laboring women were randomized by systematic sampling when admitted for hospitalization. Three ways of third stage of labor management were compared: a) assisted, using intraumbilical oxytocin; b) expectant with partial clamping of the umbilical cord (by clamping only the fetal end of the umbilical cord); and c) routinary or expectant with double clamping of the umbilical cord. 60 pregnant women were randomized to each group. Main outcome measures: Duration of the third stage of labor, prepartum and 24 hours postpartum hematocrit, complications. Results: There was a significant reduction in the time of the third stage of labor and in the variation of the hematocrit values with the assisted management and the expectant method compared to routine management in patients who did not have episiotomy. There were no significant differences in puerperal hemorrhage. Conclusions: Assisted and expectant management of the third stage of labor were more efficacious compared to routine management of the third stage of labor. Safety was similar in the three groups studied.

Key words: Third stage of labor, assisted, expectant and routinary management.

Downloads

Download data is not yet available.

References

Instituto Nacional de Estadística e Informática 2011. Perú: Encuesta Demográfica y de Salud Familiar 2011:175. Disponible en: http://proyectos.inei.gob.pe/endes/2011/

Paxton A, Wardlaw T. Are we making progress in "maternal mortality". N Engl J Med. 2011;26(21):1990-3.

ENDES 2004. “Encuesta demográfica y de salud familiar: ENDES continua 2004- 2006” Informe principal. INEI/USAID. 2007:359.

Leduc D, Senikas V, Lalonde AB, Ballerman C, Biringer A, Delaney M, et al. Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. J Obstet Gynaecol Can. 2009;31(10):980-93.

Begley CM, Gyte GM, Devane D, McGuire W, Weeks A. Active versus expectant management for women in the third stage of labour. Cochrane Database Syst Rev. 2011 9;(11):CD007412.

McDonald S, Abbott JM, Higgins SP. Prophylactic ergometrine-oxytocin versus oxytocin for the third stage of labour. Cochrane Database Syst Rev. 2004;(1):CD000201.

Su LL, Chong YS, Samuel M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst Rev. 2007;18(3):CD005457.

Dahiya P, Puri M, Rathe S. Influence of intraumbilical vein oxytocin on the third stage of labour. Indian J Med Sci.1995;49(2):23-7.

Kovavisarach E, Rojas Sangruang. Effect of umbilical vein injection on the third stage of labour: randomized controlled study. J Med Assoc Thai. 1998;81(9):693-7.

Yuen PM, Chang NS, Yim SF, Chang AM. A randomized double blind comparison of syntometrine and syntocinon in the management of the third stage of labour. Br J Obstet Gynecol. 1995;102:377-80.

Chumbe M. Córdova M. Uso de oxitocina intraumbilical en el tercer periodo parto en gestantes con anemia. (UNMSM Facultad de Medicina Tesis para Optar el Título

de Especialista en Ginecoobstetricia). Lima Perú. 1999:25pp.

Mori R, Nardin JM, Yamamoto N, Carroli G, Weeks A. Umbilical vein injection for the routine management of third stage of labour. Cochrane Database Syst Rev. 2012; 3:CD006176.

Soltani H, Poulose TA, Hutchon DR. Placental cord drainage after vaginal delivery as part of the management of the third stage of labour. Cochrane Database Syst Rev. 2011;(9):CD004665.

Jongkolsiri P, Manotaya S. Placental cord drainage and the effect on the duration of third stage labour, a randomized controlled trial. J Med Assoc Thai. 2009;92(4):457-60.

Sharma JB, Pundir P, Malhotra M, Arora R. Evaluation of placental drainage as a method of placental delivery in vaginal deliveries. Arch Gynecol Obstet. 2005;271(4):343-5.

Thomas IL, Jeffers TM, Brazier JM, Burt CL, Barr KE. Does cord drainage of placental blood facilitate delivery of the placenta? Aust N Z J Obstet Gynaecol. 1990;30(4):314-8.

Gutarra C, Leyton V. Pinzamiento del cordón placentario práctica inútil y perjudicial. XIII Congreso Peruano de Obstetricia y Ginecología. Marzo-2000.

Hofmery GJ, Nikodem VC, De Pager M, Gelbart BR. A randomized placebo controlled trial of oral misoprostol in the third stage of labour. Br J Obstet Gynecol. 1998;105(9):971-5.

Alva J, Alva H, Canales J. Eficacia del misoprostol vía sublingual comparado con la via oral en el tercer periodo del Parto. Ginecol Obstet (Perú). 2000;46:53-7.

Walraven G, Blum J, Dampha Y, Sowe M, Morison L, Winikoff B, Sloan N. Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: a randomised controlled trial. BJOG. 2005;112(9):1277-83.

Walley RL, Wilson JB, Crane JM, Matthews K, Sawyer E, Hutchens D. A double-blind placebo controlled randomised trial of misoprostol and oxytocin in the management of the third stage of labour. BJOG. 2000;107(9):1111-5.

Parsons SM, Walley RL, Crane JM, Matthews K, Hutchens D. Oral misoprostol versus oxytocin in the management of the third stage of labour. J Obstet Gynaecol Can. 2006;28(1):20-6.

Calvert C, Thomas SL, Ronsmans C, Wagner KS, Adler AJ, Filippi V. Identifying regional variation in the prevalence of postpartum haemorrhage: a systematic review and meta-analysis. PLoS One. 2012;7(7):e41114.

Cabrera S. Hemorragia posparto. Rev peru ginecol obstet. 2010;56(1).

Published

2013-10-12

How to Cite

Vilchez, R. G., Solórzano, T. C., & Cuba, F. S. (2013). Third stage of labor assisted with intraumbilical oxytocin: expectant and routinary. The Peruvian Journal of Gynecology and Obstetrics, 58(4), 285–290. https://doi.org/10.31403/rpgo.v58i45

Issue

Section

Artículos Originales