Does route matter? Impact of route of oxytocin administration on postpartum bleeding: A double-blind, randomized controlled trial

Autoři: Jill Durocher aff001;  Ilana G. Dzuba aff001;  Guillermo Carroli aff002;  Elba Mirta Morales aff003;  Jesus Daniel Aguirre aff003;  Roxanne Martin aff001;  Jesica Esquivel aff003;  Berenise Carroli aff002;  Beverly Winikoff aff001
Působiště autorů: Gynuity Health Projects, New York, New York, United States of America aff001;  Centro Rosarino de Estudios Perinatales (CREP), Rosario, Argentina aff002;  Hospital Materno Neonatal E.T. de Vidal, Corrientes, Argentina aff003
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



We assessed the impact of intravenous (IV) infusion versus intramuscular (IM) oxytocin on postpartum blood loss and rates of postpartum hemorrhage (PPH) when administered during the third stage of labor. While oxytocin is recommended for prevention of PPH, few double-blind studies have compared outcomes by routes of administration.


A double-blind, placebo-controlled randomized trial was conducted at a hospital in Argentina. Participants were assigned to receive 10 IU oxytocin via IV infusion or IM injection and a matching saline ampoule for the other route after vaginal birth. Blood loss was measured using a calibrated receptacle for a 1-hour minimum. Shock index (SI) was also calculated, based on vital signs measurements, and additional interventions were recorded. Primary outcomes included: the frequency of blood loss ≥500ml and mean blood loss.


239 (IV infusion) and 241 (IM) women were enrolled with comparable baseline characteristics. Mean blood loss was 43ml less in the IV infusion group (p = 0.161). Rates of blood loss ≥500ml were similar (IV infusion = 21%; IM = 24%, p = 0.362). Women in the IV infusion group received significantly fewer additional uterotonics (5%), than women in the IM group (12%, p = 0.007). Women with PPH in the IM group experienced a larger increase in SI after delivery, which may have influenced recourse to additional interventions.


The route of oxytocin administration for PPH prevention did not significantly impact measured blood loss after vaginal birth. However, differences were observed in recourse to additional uterotonics, favoring IV infusion over IM. In settings where IV lines are routinely placed, oxytocin infusion may be preferable to IM injection.

Klíčová slova:

Intravenous injections – Labor and delivery – Postpartum hemorrhage – Prophylaxis – Randomized controlled trials – Routes of administration – Oxytocin


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2019 Číslo 10
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