Title
The LENTE Study: The Effectiveness of Prophylactic Intramuscular Oxytocin in the Third Stage of Labor Among Low-Risk Women in Primary Care Midwifery Practice: A Randomized Controlled Trial
Author
Jans, S.M.P.J.
Herschderfer, K.C.
van Diem, M.T.
Aitink, M.
Rijnders, M.
van der Pal-de Bruin, K.
Buitendijk, S.E.
Publication year
2016
Abstract
Purpose: To test third stage management of labor for low-risk women comparing routine prophylactic intramuscular oxytocin management versus modified expectant management. Study designN: Randomized controlled multicenter trial in primary care midwifery practice. Major findings: 32.4% of women in the prophylactic intramuscular oxytocin management group had blood loss of 500 mL or more versus 44.2% in the modified expectant management group, relative risk (RR) 0.61, 95% confidence interval (CI) [0.50, 0.74]. The percentage of women experiencing postpartum hemorrhage (PPH) defined as more than 1,000 mL blood loss was 6.3% in the prophylactic intramuscular oxytocin management group versus 11.9% in the modified expectant management group (RR 0.50, 95% CI [0.36, 0.71]). The type of management showed no significant differences between the two groups in clinically relevant indicators of women’s short-term health such as the number of referrals, treatment given, hemoglobin level 36 hours postpartum, and breastfeeding rates after 1 week. Medium-term health such as hemoglobin level at 6 weeks postpartum, women’s perceptions of tiredness, and breastfeeding rates at 3 months after birth also showed no differences between the two groups. Conclusion: Third stage management by means of routine prophylactic intramuscular oxytocin reduced the risk of postpartum hemorrhage in a group of childbearing women at low risk of complications in primary midwifery care compared to modified expectant third stage management, but there was no evidence this was associated with a reduction in clinically relevant adverse health outcomes.
Subject
Life
CH - Child Health
ELSS - Earth, Life and Social Sciences
Healthy for Life
Health
Healthy Living
Postpartum hemorrhage
Primary midwifery care
Third stage management
Maternal and child health
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DOI
https://doi.org/10.1891/2156-5287.6.3.173
TNO identifier
562826
Source
International Journal of Childbirth, 16 (3), 173-182
Document type
article