| 20040309-7* Prophylactic ergometrine-oxytocin
versus oxytocin for the third stage of labour (Cochrane Review). (Date of
most recent substantive amendment: 25 September 2003)
- The Cochrane Database of Systematic
Reviews , issue 1, 2004 McDonald S; Abbott JM; Higgins SP
- (2004) |
| |
Compared with oxytocin, ergometrine-oxytocin
was associated with a small reduction in the risk of PPH using the
definition of PPH of blood loss of at least 500 ml (odds ratio 0.82, 95%
confidence interval 0.71 to 0.95). This advantage was found for both a
dose of 5 iu oxytocin and a dose of 10 iu oxytocin, but was greater for
the lower dose. There was no difference detected between the groups using
either 5 or 10 iu for the stricter definition of PPH of blood loss at
least 1000 ml. Adverse effects of vomiting, nausea and hypertension were
more likely to be associated with the use of ergometrine-oxytocin. When
heterogeneity between trials was taken into account there were no
statistically significant differences found for the other maternal or
neonatal outcomes. Reviewers' conclusions: The use of ergometrine-oxytocin
as part of the routine active management of the third stage of labour
appears to be associated with a small but statistically significant
reduction in the risk of PPH when compared to oxytocin for blood loss of
500 ml or more. No statistically significant difference was observed
between the groups for blood loss of 1000 ml or more. A statistically
significant difference was observed in the presence of maternal
side-effects, including elevation of diastolic blood pressure, vomiting
and nausea, associated with ergometrine-oxytocin use compared to oxytocin
use. Thus, the advantage of a reduction in the risk of PPH, between 500
and 1000 ml blood loss, needs to be weighed against the adverse
side-effects associated with the use of ergometrine-oxytocin.
(Author) |
|
