Intramuscular versus intravenous oxytocin to prevent postpar
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Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality worldwide, accounting for nearly a quarter of maternal deaths. PPH associated morbidity includes anemia, maternal exhaustion, difficulty breastfeeding, blood transfusion, emergency surgery, and admission to a high dependency or intensive care unit. The most common underlying cause of PPH is uterine atony. A study was conducted to determine whether intravenous oxytocin is more effective than intramuscular oxytocin at preventing postpartum hemorrhage at vaginal delivery.

1075 women were randomized and 1035 (96.3%) included in the primary and secondary analyses (517 in the intravenous oxytocin group and 518 in the intramuscular oxytocin group). The incidence of PPH was not significantly lower in the intravenous group compared with the intramuscular group. The incidence of severe PPH, however, was significantly lower in the intravenous group compared with the intramuscular group as was the need for blood transfusion and admission to a high dependency unit. The incidence of side effects to oxytocin was not increased in the intravenous group compared with the intramuscular group.

In Conclusion intravenous oxytocin for the third stage of labor results in less frequent severe PPH, blood transfusion, and admission to a high dependency unit than intramuscular oxytocin, and without excess side effects.

Source: https://www.bmj.com/content/362/bmj.k3546
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