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vol.106 número4The other side of surveillance: Monitoring, application, and integration of tuberculosis data to guide and evaluate programme activities in South AfricaEvaluating current knowledge of legislation and practice of obstetricians and gynaecologists in the management of fetal remains in South Africa índice de autoresíndice de assuntospesquisa de artigos
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SAMJ: South African Medical Journal

versão On-line ISSN 2078-5135
versão impressa ISSN 0256-9574


KOEN, S; SNYMAN, L C; PATTINSON, R C  e  MAKIN, J A. A randomised controlled trial comparing oxytocin and oxytocin + ergometrine for prevention of postpartum haemorrhage at caesarean section. SAMJ, S. Afr. med. j. [online]. 2016, vol.106, n.4, pp.399-402. ISSN 2078-5135.

BACKGROUND: Globally 166 000 women die annually as a result of obstetric haemorrhage. More than 50% of these deaths occur in sub-Saharan Africa. Uterine atony is the commonest cause of severe postpartum haemorrhage (PPH). Bleeding at or after caesarean section (CS) is responsible for >30% of maternal deaths due to obstetric haemorrhage in South Africa (SA OBJECTIVE: To compare oxytocin alone with oxytocin + ergometrine in terms of primary prophylaxis for PPH at the time of CS METHODS: This was a double-blind randomised controlled interventional study comparing oxytocin with oxytocin + ergometrine administered during CS. Patients were randomised to receive oxytocin alone intravenously as a bolus or oxytocin + ergometrine intramuscularly, with the placebo being an injection of sterile water. The study population consisted of women undergoing CS at Kalafong Provincial Tertiary Hospital in Atteridgeville, Gauteng, SA RESULTS: Five hundred and forty women were randomised and data for 416 women, of whom 214 received oxytocin and 202 oxytocin + ergometrine, were available for analysis. In the oxytocin group 19 women (8.9%) required blood transfusion, compared with seven (3.5%) in the oxytocin + ergometrine group (p=0.01; relative risk = 2.78; 95% confidence interval 1.21 - 6.4). There were no statistically significant differences in the mean estimated visual and mean calculated blood loss CONCLUSIONS: The overall need for blood transfusion was significantly reduced by about two-thirds in women receiving the oxytocin + ergometrine combination. Consideration should be given to using oxytocin + ergometrine for prophylaxis of PPH at CS

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