Administering a Uterotonic at Delivery Lowers Risk for Postpartum Hemorrhage — But Route Matters

Oxytocin administered at delivery reduces risk for postpartum hemorrhage (PPH) by stimulating uterine contraction. To identify the most effective route of administration, 1075 pregnant women having vaginal deliveries in Ireland were randomized to receive 10 units of oxytocin by intravenous bolus (IV) or intramuscular injection (IM).

Mean postpartum blood loss was 385 mL (IV group) versus 445 mL (IM group; P<0.01). Severe PPH (blood loss ≥1000 mL) occurred in 4.6% versus 8.1% of the IV and IM groups, respectively (adjusted odds ratio, 0.5; P<0.02), and a blood transfusion was necessary in 1.5% (IV) versus 4.4% (IM; aOR, 0.3; P<0.005). The number of women needed to treat with IV rather than IM oxytocin to prevent one severe case of PPH or one …