Carboprost Versus Oxytocin for Active Management of Third Stage of Labor: A Prospective Randomized Control Study.

Journal of obstetrics and gynaecology of India

PubMedID: 27651609

Sunil Kumar KS, Shyam S, Batakurki P. Carboprost Versus Oxytocin for Active Management of Third Stage of Labor: A Prospective Randomized Control Study. J Obstet Gynaecol India. 2016;66(Suppl 1):229-34.
BACKGROUND AND OBJECTIVES
Postpartum hemorrhage is the single largest and leading cause of maternal morbidity and mortality not only in developing countries but also in developed countries. The present study is an attempt to evaluate the scope of using prophylactic intramuscular carboprost tromethamine 125 µg in comparison with intramuscular oxytocin 10 units for the active management of third stage of labor.

MATERIALS AND METHODS
Two hundred pregnant women at term with spontaneous onset of labor were included in the study and were randomly divided into 2 groups of 100 women each. Group A and group B were given injection oxytocin 10 units and injection carboprost tromethamine 125 µg intramuscularly, respectively, at the time of delivery of anterior shoulder. The main outcome measures with respect to third stage of labor were: duration, blood loss by volume, difference in hemoglobin, need for additional oxytocics and side effects.

RESULTS
Subjects who received carboprost tromethamine 125 µg showed a significant reduction in duration of third stage of labor (p < 0.05) and blood loss (p < 0.01) when compared to the subjects who received oxytocin 10 units. Likelihood of occurrence of postpartum hemorrhage was reduced without significant side effects except for diarrhea. Additional need for other uterotonics after carboprost was significantly less compared to oxytocin.

CONCLUSION
Intramuscular carboprost 125 µg is a better cost-effective alternative as compared to 10 units intramuscular oxytocin in active management of third stage of labor.