Postpartum hemorrhage is one of the common complications of vaginal delivery. Oxytocin is accepted prevention for vaginal hemorrhage, but whether it is more effective in intramuscular or intravenous form is not clear. This study aims to compare the effectiveness of intramuscular and intravenous oxytocin for the prevention of postpartum hemorrhage during vaginal delivery.

This is a double-blind, randomized, placebo-controlled trial conducted on a total of 1,035 women aged 18 and older, who were in the third stage of labor and were aiming for a vaginal delivery. The women were randomly allocated to an intravenous bolus of oxytocin (517) or placebo intramuscular injection (518). The primary outcome of the study was postpartum hemorrhage, admission to a high dependency unit, or the need for blood transfusion.

The incidence of postpartum hemorrhage was not significantly lower in the intravenous group (18.8%), compared with the intramuscular group (23.2%). However, the incidence of severe hemorrhage was lower in the intravenous group. The need for blood transfusion (1.5 vs. 4.4%) and admission to a high dependency unit (1.7 vs. 3.7%) was also lower in the intravenous group.

The research concluded that intravenous oxytocin was associated with a less frequent severe postpartum hemorrhage, need for blood transfusion, and admission to a high dependency unit.

Ref: https://www.bmj.com/content/362/bmj.k3546