A comparison of prophylactic intramuscular ergometrine and oxytocin for women in the third stage of labor

Objective

To compare the efficacy and adverse effects of ergometrine and oxytocin given intramuscularly for the prevention of postpartum hemorrhage during the third stage of labor.

Methods

The study included women with a singleton pregnancy of at least 28 weeks’ gestation who had a vaginal delivery. High-risk pregnancies were excluded. Oxytocin (10 IU) or ergometrine (0.5 mg) were administered intramuscularly in a blinded pattern immediately after delivery of the infant. An intention-to-treat analysis was performed.

Results

Postpartum blood loss (301.8 ± 109.2 mL versus 287.1 ± 84.4 mL, P = 0.011) and packed cell volume (30.7 ± 1.7% versus 31.6 ± 2.0%; Z = 0.00; P = 0.008) were considerably reduced among parturients who received intramuscular ergometrine. The rates of therapeutic oxytocics use, blood transfusion, placental retention, and manual removal of the placenta were significantly higher in the oxytocin group. No significant differences between the groups were observed in terms of adverse effects, with the exception of diastolic hypertension, which was more common in the ergometrine group (odds ratio, 0.00; 95% confidence interval, 0.00–0.75; P = 0.007).

Conclusion

Intramuscular ergometrine is superior to intramuscular oxytocin in averting postpartum hemorrhage during the third stage of labor. There are no significant risks of adverse effects except for diastolic hypertension.Pan African Clinical Trial Registry (www.pactr.org): 201105000292708.