Postpartum use of oxytocin and volume of placental transfusion: a randomised controlled trial

Arch Dis Child Fetal Neonatal Ed. 2020 Jan;105(1):14-17. doi: 10.1136/archdischild-2018-316649. Epub 2019 May 9.

Abstract

Objective: To assess whether oxytocin administered before clamping the umbilical cord modifies the volume of placental transfusion.

Design: Randomised controlled trial.

Methods: Mothers of term infants born vigorous by vaginal delivery with informed consent provided in early labour were randomly assigned to oxytocin (10 IU) given intravenously within 15 s of birth (group 1) or after clamping the umbilical cord 3 min after delivery (group 2). Soon after birth, all infants were weighed using a 1 g precision scale and subsequently placed on the mother's abdomen or chest. At 3 min, in both groups, the cord was clamped and cut, and the weight was again obtained. The primary outcome (volume of placental transfusion) was estimated by the difference in weights.

Results: 144 patients were included. There were no differences in the primary outcome: infants in group 1 (n=70) gained a mean weight of 85.9 g (SD 48.3), and in group 2 (n=74) 86.7 g (SD 49.6) (p=0.92). No differences were found in secondary outcomes, including newborns' haematocrit and bilirubin concentrations and severe maternal postpartum haemorrhage. On the advice of the Data and Safety Monitoring Committee, the trial was stopped due to futility at 25% of the planned sample size.

Conclusions: When umbilical cord clamping is delayed for 3 min, term newborn infants born vigorous receive a clinically significant placental transfusion which is not modified by the administration of intravenous oxytocin immediately after birth.

Trial registration number: NCT02618499.

Keywords: delivery room; oxytocin; placental transfusion; umbilical cord clamping.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Bilirubin / blood
  • Birth Weight
  • Constriction*
  • Delivery, Obstetric
  • Female
  • Hematocrit
  • Hospitals, Maternity
  • Humans
  • Infant, Newborn
  • Injections, Intravenous
  • Male
  • Oxytocics / administration & dosage*
  • Oxytocin / administration & dosage*
  • Placental Circulation*
  • Postpartum Hemorrhage / prevention & control
  • Postpartum Period*
  • Pregnancy
  • Time Factors
  • Umbilical Cord*
  • Weight Gain

Substances

  • Oxytocics
  • Oxytocin
  • Bilirubin

Associated data

  • ClinicalTrials.gov/NCT02618499