Comparison of Intraumbilical Oxytocin Injection, Umbilical Cord Drainage and Intravenous Oxytocin in the Management of Third Stage of Labor /
Omar Mohamed Sameh Hamdi Nassar,
Comparison of Intraumbilical Oxytocin Injection, Umbilical Cord Drainage and Intravenous Oxytocin in the Management of Third Stage of Labor / المقارنة بين حقن الأوكسيتوسين داخل الحبل السري وتصريف الحبل السري والأوكسي توسين الوريدي في تدبير المرحلة الثالثة من المخاض / By Omar Mohamed Sameh Hamdi Nassar; Supervisors Dr. Omneya Moustafa Helal, Dr. Manal AbdRabo Mohamed Mousa, Dr. Ibrahim Fawzy Ibrahim. - 125 pages : illustrations ; 25 cm. + CD.
Thesis (M.Sc.)-Cairo University, 2024.
Bibliography: pages 118-119.
Background: The third stage of labor (TSL) is considered to start when delivery of the fetus is completed and ended when placenta and membranes have been expelled. Postpartum hemorrhage (PPH) is the commonest complication of the TSL with high risk of maternal morbidity and mortality. Considerable divergence of opinion exists as regarding the best approach for the management of the TSL
Objectives: The aim of the study is to determine the effect of umbilical vein oxytocin injection and placental cord drainage (PCD) in the management of the TSL in normal vaginal delivery compared with intra venous (IV) oxytocin infusion as a standard management of TSL.
Material and Methods: A randomized controlled trial was carried out on 300 women who underwent vaginal delivery and admitted to the delivery ward of ER unit, obstetrics and gynecology department, Kasr Al Ainy hospital. They were randomly assigned into three equal groups (100 each). Group (A) received IV infusion of 20 units oxytocin diluted in 500 ml of normal saline following fetal delivery and considered as control group. In group (B) 20 units of oxytocin diluted in 20 ml of normal saline was instilled into the umbilical vein following clamping of the cord. Whereas PCD technique was performed in group (C). Time of placental separation along with blood loss using calculated estimated blood loss were measured in all women. In addition, the need for extra uterotonics and third stage complications as postpartum hemorrhage & retained placenta were monitored.
Results: The mean duration of 3rd stage of labor was 2.07 min in group B, 3.17 min in group A and 3.41min in group C. The calculated ESBL was 231. 8 ml in group B, 265.3 ml in group A and 318.6 ml in group C. The difference in duration & blood loss were high statistically significant.
Conclusions: The present study emphasized that the intraumbilical route of oxytocin efficiently decreases blood loss during the TSL and shortens its duration compared to intravenous oxytocin injection.
اوضحت الدراسة أن حقن للأوكسيتوسين داخل الحبل السري يقلل بشكل فعال من فقدان الدم خلال المرحلة الثالثة من المخاض ويقصر مدتها مقارنة بحقن الأوكسيتوسين في الوريد. وأن الاستخدام الوقائي لهذه التقنية أثناء المخاض هي طريقة آمنة ومفيدة وعملية وغير جراحية للمعالجة الفعالة للمرحلة الثالثة. كما أوضحت الدراسة أن هناك حاجة إلى مزيد من الدراسات لاستخدام تصريف الحبل المشيمي جنبًا إلى جنب مع التقنيات القياسية للمعالجة الفعالة للمرحلة الثالثة.
Text in English and abstract in Arabic & English.
Uterine diseases
Oxytocin, third stage of labor Intraumbilical, cord drainage postpartum hemorrhage
618.14
Comparison of Intraumbilical Oxytocin Injection, Umbilical Cord Drainage and Intravenous Oxytocin in the Management of Third Stage of Labor / المقارنة بين حقن الأوكسيتوسين داخل الحبل السري وتصريف الحبل السري والأوكسي توسين الوريدي في تدبير المرحلة الثالثة من المخاض / By Omar Mohamed Sameh Hamdi Nassar; Supervisors Dr. Omneya Moustafa Helal, Dr. Manal AbdRabo Mohamed Mousa, Dr. Ibrahim Fawzy Ibrahim. - 125 pages : illustrations ; 25 cm. + CD.
Thesis (M.Sc.)-Cairo University, 2024.
Bibliography: pages 118-119.
Background: The third stage of labor (TSL) is considered to start when delivery of the fetus is completed and ended when placenta and membranes have been expelled. Postpartum hemorrhage (PPH) is the commonest complication of the TSL with high risk of maternal morbidity and mortality. Considerable divergence of opinion exists as regarding the best approach for the management of the TSL
Objectives: The aim of the study is to determine the effect of umbilical vein oxytocin injection and placental cord drainage (PCD) in the management of the TSL in normal vaginal delivery compared with intra venous (IV) oxytocin infusion as a standard management of TSL.
Material and Methods: A randomized controlled trial was carried out on 300 women who underwent vaginal delivery and admitted to the delivery ward of ER unit, obstetrics and gynecology department, Kasr Al Ainy hospital. They were randomly assigned into three equal groups (100 each). Group (A) received IV infusion of 20 units oxytocin diluted in 500 ml of normal saline following fetal delivery and considered as control group. In group (B) 20 units of oxytocin diluted in 20 ml of normal saline was instilled into the umbilical vein following clamping of the cord. Whereas PCD technique was performed in group (C). Time of placental separation along with blood loss using calculated estimated blood loss were measured in all women. In addition, the need for extra uterotonics and third stage complications as postpartum hemorrhage & retained placenta were monitored.
Results: The mean duration of 3rd stage of labor was 2.07 min in group B, 3.17 min in group A and 3.41min in group C. The calculated ESBL was 231. 8 ml in group B, 265.3 ml in group A and 318.6 ml in group C. The difference in duration & blood loss were high statistically significant.
Conclusions: The present study emphasized that the intraumbilical route of oxytocin efficiently decreases blood loss during the TSL and shortens its duration compared to intravenous oxytocin injection.
اوضحت الدراسة أن حقن للأوكسيتوسين داخل الحبل السري يقلل بشكل فعال من فقدان الدم خلال المرحلة الثالثة من المخاض ويقصر مدتها مقارنة بحقن الأوكسيتوسين في الوريد. وأن الاستخدام الوقائي لهذه التقنية أثناء المخاض هي طريقة آمنة ومفيدة وعملية وغير جراحية للمعالجة الفعالة للمرحلة الثالثة. كما أوضحت الدراسة أن هناك حاجة إلى مزيد من الدراسات لاستخدام تصريف الحبل المشيمي جنبًا إلى جنب مع التقنيات القياسية للمعالجة الفعالة للمرحلة الثالثة.
Text in English and abstract in Arabic & English.
Uterine diseases
Oxytocin, third stage of labor Intraumbilical, cord drainage postpartum hemorrhage
618.14