Maternal mortality continues to be a major public health concern inspite of the advances in technology and research. Worldwide, postpartum hemorrhage (PPH) is cited as the major cause of mortality and morbidity, more so in developing countries. Active management of third stage of labor (AMTSL) is the treatment of choice in preventing PPH.

OBJECTIVE: The goal of this study was to determine the efficacy of intraumbilical vein injection of oxytocin versus IV oxytocin infusion in the AMTSL. It is meant to provide an alternate route that is more efficacious and practical.

METHODS: In this prospective, randomized, single-blinded clinical trial comparing the efficacy of intraumbilical vein (IUV) injection of oxytocin versus oxytocin IV infusion, 80 subjects were assigned to 2 groups according to the route of oxytocin. Primary outcome measures were duration of third stage of labor and amount of blood loss. Secondary outcome measures were the need for additional uterotonic agent, need for transfusion, uterine tone and acceptability to the examiner.

RESULTS: Blood loss was significantly lower in the IUV group compared to IV group (386.11±214.49 vs 516.22±139.95) while duration of third stage was longer in the IUV group (318±190.31 vs 271.49±200.60). The difference in hemoglobin pre and post-delivery is significantly lower in the UIV group (0.85±0.84 vs 1.29±1.13). Adequate uterine tone was achieved immediately after IUV oxytocin, thereby eliminating the need for Methylergometrine.

CONCLUSION: Intraumbilical vein injection of oxytocin in the active management of labor is an effective alternate route in preventing postpartum hemorrhage.