Use of oxytocin during early stages of labor and its effect on active management of third stage of labor

Am J Obstet Gynecol. 2011 Mar;204(3):238.e1-5. doi: 10.1016/j.ajog.2010.10.005. Epub 2010 Dec 8.


Objective: The purpose of this study was to evaluate whether the use of oxytocin during the first and second stages of labor is associated with a higher incidence of postpartum hemorrhage (PPH) in pregnant women who received active management of third stage of labor (AMTSL).

Study design: A secondary data analysis from vaginal deliveries in a hospital-based cohort study from 24 maternity hospitals in South America. The primary outcomes that were analyzed were moderate PPH (≥500 mL of blood loss), severe PPH (≥1000 mL of blood loss), and need of blood transfusion.

Results: A total of 11,323 vaginal deliveries were included. The incidence of moderate and severe PPH was 10.8% and 1.86%, respectively. Overall, 36% of deliveries received AMTSL. There was no association between induced/augmented labor and moderate PPH (P = .753), severe PPH (P = .273), and blood transfusion (P = .603) in the population that received AMTSL.

Conclusion: AMTSL should be recommended, regardless of whether pregnant women received oxytocin during the first and second stages of labor.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Delivery, Obstetric / methods
  • Female
  • Humans
  • Incidence
  • Labor Stage, First
  • Labor Stage, Second
  • Labor Stage, Third / drug effects*
  • Oxytocics / administration & dosage*
  • Oxytocics / adverse effects
  • Oxytocin / administration & dosage*
  • Oxytocin / adverse effects
  • Postpartum Hemorrhage / chemically induced
  • Postpartum Hemorrhage / etiology*
  • Pregnancy
  • Young Adult


  • Oxytocics
  • Oxytocin