A Randomized Controlled Study of Prostaglandin 15‐Methyl F2 alpha Compared With Syntometrine for Prophylactic Use in the Third Stage of Labour

Abstract

A randomized controlled study of 112 women with singleton pregnancies at term, and no antenatal complications, admitted in spontaneous labour were randomized to receive either an intramuscular injection of 0.5 mg of Syntometrine or an intramuscular injection of 125 ug of prostaglandin 15-methyl F2 alpha at delivery of the anterior shoulder of the baby. Blood lost in the first 2 hours, and subsequent 22 hours postdelivery were collected separately and measured by colourimetric measurement of haemoglobin content. Other parameters in the third stage were measured, including need for transfusion of blood or blood products, length of the third stage, and change in haemoglobin concentration before and 24 hours after delivery. The incidence of side-effects with administration of either prostaglandin 15-methyl F2 alpha or Syntometrine were documented. The prophylactic use of intramuscular prostaglandin 15-methyl F2 alpha (Carboprost) in the active management of the third stage of labour gave similar results to prophylactic intramuscular Syntometrine in terms of length of the third stage of labour, incidence of postpartum haemorrhage and total blood loss in the first 2 hours and subsequent 22 hours after delivery. However it has the disadvantage of higher cost, as well as statistically significant increase in the incidence of profuse and frequent diarrhoea. Based on these results intramuscular injection of prostaglandin 15-methyl F2 alpha offers no advantage over intramuscular Syntometrine for routine prophylactic use to reduce blood loss in the third stage of labour.

Active Management of Third Stage of Labor: A Comparison of Various Uterotonic

“…Tachycardia was observed in 36% patients which were attributed to increased blood loss in this group. This is comparable to the study of Chua S et al (1995) where they found a significant increase in the incidence of diarrhea with prostidin. 12 In group D, minor side effects, like shivering and fever, were present in 48% and 56% of patients.…”

“…This is comparable to the study of Chua S et al (1995) where they found a significant increase in the incidence of diarrhea with prostidin. 12 In group D, minor side effects, like shivering and fever, were present in 48% and 56% of patients. Our study is consistent with the study of El Refaey et al (1997), Hofmeyer GJ et al (1998), F Amant et al (1999), Hazem El-Rafaey et al (2000) in which their patients also exhibited fever and shivering.…”

A comparative study of oxytocin, carboprost, methylergometrine and misoprostol in prevention of postpartum haemorrhage a prospective study

“…In group D, minor side effects, like shivering and fever, were present in 48% and 56% of patients. Our study is consistent with the study of El Refaey et al (1997), Hofmeyer G J et al (1998), F Amant et al (1999), Hazem El-Rafaey et al (2000) in which their patients also exhibited fever and shivering [22,23,25].…”

“…In group B Diarrhea and vomiting were most commonly observed inalong with chills in only 12%. This is comparable to the study of Chua S et al (1995) where they found a significant increase in the incidence of diarrhea with prostidin [24].…”

Role of carboprost in prevention of postpartum hemorrhage

“…6 In the present study mean duration of third stage of labour was 5.03±1.9 minutes in carboprost group. Our results are in accordance with the study of Yuen PH et al and Chua S et al 7,8 Bhide P et al studied the use of oxytocin, methylergometrine and carboprost during third stage of labour and found that the duration of 3 rd stage was 6 minutes 30 seconds, 5 minutes and 3 minutes 15 seconds respectively. 6 The results of our study do not match with those of the following studies.…”