Comparison of intramuscular syntometrine and intravenous oxytocin in management of the third stage of labor

Abstract Background: One of the main etiologies of maternal mortality is obstetrical hemorrhage. The first step in decreasing hemorrhage is the use of uterotonic drugs in the third stage of labor. Objective: To compare the efficacy and safety of intravenous oxytocin and intramuscular syntometrine in management of the third stage of labor. Methods: This randomized double blind clinical trial was carried out at Kosar Hospital, Qazvin (Iran) in 2005. A total of 800 women having a singleton pregnancy and vaginal delivery were randomized to receive either 1 ml of syntometrine intramuscularly, or 10 units of intravenous oxytocine following delivery of the anterior shoulder of fetus. Hemoglobin level pre- and 24 hours post-delivery, duration of third stage, need for re-administration of uterotonic drugs, need for manual removal of placenta, and unpleasant side effects including nausea, vomiting, headache and hypertension were recorded. The data were analyzed using chi-square test. Findings: Mean drop percent of hemoglobin level in oxytocin group was 3.7±2.54% and in syntometrine group 3.6±2.49% with no significant difference, statistically. There was also no statistically significant difference between the need for re-administration of uterotonic drugs, duration of third stage of labor, need for manual removal of placenta and the maternal side effect in two groups. Conclusion: Regarding the efficacy and side effects of intravenous oxytocin and intramuscular syntometrine, no difference was found.