Cochrane Summaries

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Prophylactic oxytocin for the third stage of labour

Westhoff G, Cotter AM, Tolosa JE
Published Online: 
30 October 2013

Prophylactic oxytocin at any dose used routinely after birth can reduce blood loss with fewer side effects than ergot alkaloids.

The third stage of labour is that period from birth of the baby until delivery of the placenta, however, complications can continue to occur once the placenta is removed. The degree of blood loss during this stage depends, among other factors, on how quickly the uterine muscle contracts and the placenta separates from the uterine wall. Postpartum haemorrhage is a major problem, particularly where there is poor nutrition and lack of access to treatment. This review of 20 trials (involving 10,806 women) found that the routine use of prophylactic oxytocin, a drug that helps the uterus contract, may reduce the amount of blood loss during the third stage of labour. Prophylactic oxytocin is better at preventing blood loss compared with ergot alkaloids, however, no further improvement is seen when they were used together. More research is needed, especially in low- and middle-income countries, on the best method to implement this intervention in the third stage for women in all countries, on the dose to use, and the best route for administration (intramuscular or intravenous).