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PubMed1997

Midtrimester pregnancy termination for fetal malformations. Use of intravaginal prostaglandin E2.

OBJECTIVE: To compare outcome differences and responses to treatment in pregnancies complicated by either major fetal malformations or previous fetal death in the second trimester. STUDY DESIGN: Data were analyzed from a computerized perinatal database and individual hospital records for singleton gestations between 14 and 23 weeks undergoing labor induction with prostaglandin E2 (PGE2) suppositories (20 mg intravaginally every three to five hours). RESULTS: Between January 1993 and June 1995, 65 pregnancies underwent induction of labor for either a lethal fetal malformation (38) or death (27). As compared with the fetal death group, the malformation group required more suppositories (median 4, range 1-10, versus median 3, range 1-6; P < .05) and needed a greater total dosage (77.5 +/- 38.5 mg versus 61.8 +/- 37.8 mg, P < .05). The mean time from initiation of treatment until delivery was two hours longer in the malformation group. There were no significant differences between the two treatment groups in incidence of maternal side effects or of retained placentas requiring operative intervention. CONCLUSION: Patients who undergo second-trimester induction of labor for major fetal malformations using intravaginal PGE2 should be counseled that the dosage of the drug is greater and that labor may last longer than in pregnancies complicated by a previous fetal death.

Abortion, Induced↗

PubMed1997

New techniques using transcervical uterine cannulation for the diagnosis of uterine disorders in bitches.

A technique for collecting uterine samples from bitches without the need for surgery was developed. This technique involved visualizing the cervix with a rigid endoscope and passing a catheter through the cervix into the uterus. Samples for microbiology and cytology were obtained by the infusion and aspiration of sterile normal saline. This technique allowed uterine microbiology and cytology of the normal bitch throughout the reproductive cycle. Microorganisms were frequently recovered from the uterus during pro-oestrus and oestrus, but rarely at other stages of the reproductive cycle. The uterine microflora often reflected the vaginal microflora during pro-oestrus and oestrus. The cells found in uterine cytology samples from normal bitches included endometrial epithelial cells, leukocytes, erythrocytes, cervical cells, spermatozoa and bacteria. The types, proportions, morphology and numbers of cells varied throughout the reproductive cycle. The endoscope could be passed into the uterus and the endometrium examined from parturition until day 23 post partum. These procedures and contrast hysterography were used to investigate the reproductive tract of bitches. The above techniques have facilitated the diagnosis of postpartum metritis (n = 3), pyometra (n = 2), endometritis (n = 1), abortion (n = 1), retained placenta (n = 1), postpartum uterine rupture (n = 1), endometrial subinvolution (n = 1) and misalliance (n = 1) in 21 bitches investigated.

Abortion, Veterinary↗

PubMed1998

[Effect of estrogens on the immune system with regard to bovine placental retention].

A survey of effects of estrogens on the immune system is given by a literature study. Changes in number and functionality of single populations of cells of the immune system are shown. Results often vary in dependence on the examined parameters, on the type of the used or measured estrogens, on the measuring methods and between the different species. Independent from that the capacity of the nonspecific cellular immune system seems to be increased under the influence of estrogens. Individuals with high estrogen levels showed an increase of the number of leucocytes and neutrophil granulocytes in the blood. In most of the functional studies on neutrophil granulocytes a suppressive effect of estrogens independent from the species could only be observed on the ability of directed migration. A stimulation or no effects of estrogens were reported on all the other parameters (random migration, phagocytosis, generation of reactive oxygen metabolites, cytotoxicity). Less is known about the effects of estrogens on mononuclear cells (lymphocytes, monocytes, natural killer cells). Mainly lymphocytes showed a decrease in their number in the blood and a suppressive effect of isolated cells in different species. It remains for further studies whether estrogens are of significance for bovine retained placenta by having effects on components of the immune system, and how significant they are.

Animals↗

PubMed1998

Evaluation of prostaglandin F2 alpha treatment in dairy cows at risk for low fertility after parturition.

OBJECTIVE: To evaluate the effect of 2 postpartum prostaglandin F2 alpha (PGF 2 alpha) treatment protocols on reproductive performance of dairy cows at risk for low fertility. In addition, various medical conditions in cows that are recognized as having adverse effects on fertility were evaluated as criteria for fertility treatment. DESIGN: Prospective study. ANIMALS: 291 cows with, and 271 cows without, risk factors for low fertility. PROCEDURE: Cows at risk for low fertility were randomly assigned to 2 treatment groups. Group-1 cows received 3 i.m. injections of PGF2 alpha at weekly intervals after parturition, and group-2 cows received 1 i.m. injection of PGF2 alpha 17 to 24 days after parturition. RESULTS: Compared with a single PGF2 alpha treatment 17 to 24 days after parturition, there was no added benefit of 3 treatments with PGF2 alpha 3 to 10, 10 to 17, and 17 to 24 days after parturition in cows at risk for low fertility. Cows without risk factors for low fertility had 20% higher pregnancy rates, compared with cows with risk factors for low fertility. Twinning had a negative effect on future fertility. CLINICAL IMPLICATIONS: Results of this study indicate that further consideration should be given to the timing and intervals of PGF2 alpha administration after parturition. Risk factors for low fertility, such as retained placenta, twins, and assisted calvings, are valid criteria to evaluate different treatment options to improve fertility in dairy cows.

Animals↗

PubMed1995

Third stage of labor: analysis of duration and clinical practice.

OBJECTIVES: Our purpose was to record gestational age-specific data for third-stage duration of labor, frequencies of retained placentas (undelivered at 30 minutes), manual removal of the placenta, and hemorrhage. STUDY DESIGN: Included were 45,852 singleton deliveries > or = 20 weeks' gestation from 1984 to 1992. Odds ratios, 95% confidence intervals, and actuarial life analysis with censoring of cases with manual placenta removal were performed. RESULTS: The frequency of retained placentas (2.0% overall) was markedly increased among gestations < or = 26 weeks (odds ratio 20.8, 95% confidence interval 17.1 to 25.4) and < 37 weeks (odds ratio 3.0, 95% confidence interval 2.6 to 3.5) compared with term. The frequency of manual removal (3.0% overall) was increased among gestations < or = 26 weeks (odds ratio 9.2, 95% confidence interval 7.5 to 11.4) and < 37 weeks (odds ratio 2.8, 95% confidence interval 2.4 to 3.1) compared with term. Hemorrhage (3.5% overall) was increased among subjects with manual placenta removal (odds ratio 10.4, 95% confidence interval 9.1 to 11.9); hemorrhage was also increased among gestations < or = 26 weeks (odds ratio 3.0, 95% confidence interval 2.3 to 4.0) and < 37 weeks (odds ratio 1.2, 95% confidence interval 1.01 to 1.3) compared with term. The frequency of hemorrhage peaked by 40 minutes regardless of gestational age. Life-table analysis predicted 90% of placentas would spontaneously deliver by 180 minutes for gestations at 20 weeks, 21 minutes at 30 weeks, and 14 minutes at 40 weeks; the predicted frequency of retained placentas was 42% higher than the recorded incidence. CONCLUSIONS: The duration of the third stage decreases and the frequencies of hemorrhage and manual removal decrease with increasing gestational age. Hemorrhage was associated with manual placental removal. Life-table analysis indicated that manual removal of placentas shortened the duration of the third stage of labor, especially among preterm deliveries. A prospective trial is needed to determine whether manual placental removal can reduce hemorrhage among prolonged third stages.

Female↗

PubMed2004

Postpartum haemorrhage in nulliparous women: incidence and risk factors in low and high risk women. A Dutch population-based cohort study on standard (> or = 500 ml) and severe (> or = 1000 ml) postpartum haemorrhage.

OBJECTIVE: To determine the incidence and risk factors for standard and severe postpartum haemorrhage (PPH) in vaginally delivering nulliparous women, before and after risk stratification. STUDY DESIGN: A population-based cohort study in an unselected cohort nulliparous women (N = 3464) in 'The Zaanstreek' district, The Netherlands. Risk stratification is part of routine care, where midwives cover all obstetrical care for women with low risk pregnancies. RESULTS: The incidence of standard PPH (> or = 500 ml) and severe PPH (> or = 1000 ml) were 19 and 4.2%, respectively. A retained placenta occurred in 1.8%. These data show consistently slightly higher values as compared to studies in literature. The most important risk factors for standard and severe PPH were related to an abnormal third stage of labour-third stage > or = 30 min and retained placenta (in severe PPH: odds ratio (OR) 14.1, 95% confidence interval (CI) 10.4-19.1). High birth weight and perineal damage were less important, but independent, significant risk factors. In the low risk group (N = 1416), incidence of severe PPH was 4.0%. Independent risk factors for severe PPH were third stage > or = 30 min (incidence 7.1%, OR 3.6) and retained placenta (incidence 1.2%, OR 21.6). In 25% of the women with a prolonged third stage (> or = 30 min), third stage was complicated due to retained placenta and/or severe PPH (1.8% of the low risk group). CONCLUSIONS: The incidence of PPH in nulliparous women in this cohort was on average higher than published data, while the most important risk factors for standard and severe PPH, even after risk stratification, were the same. A prolonged third stage of labour has to be considered as abnormal, requiring specific action.

Cohort Studies↗

PubMed1990

An ecological analysis of risk factors for postpartum disorders of Holstein-Friesian cows from thirty-two New York farms.

Path analysis and multiple logistic-normal regression were used to model the interrelationships between stated herd management practices and herd 30-d postpartum incidence rates of dystocia, retained placenta, and clinical postpartum metritis, cystic ovary, milk fever, ketosis, left displaced abomasum, and mastitis. Management risk factors were obtained from a personal interview questionnaire. Data were from 2141 multiparous Holstein calvings from May 1981 through April 1982 in 32 commercial herds in the vicinity of Cornell University. Farms where the stated policy was to administer low calcium diets to the dry cows experienced more dystocia and retained placenta. More dystocia was experienced on farms where the stated policy was to administer extra vitamin D to dry cows, where dry cows were housed with the milking cows, or where calving occurred in maternity pens rather than stanchions. There was an increased likelihood of milk fever and left displaced abomasum on farms on which the stated policy was to lead feed. Farms where dairy farmers treated cases of retained placenta had more retained placenta than farms on which the treatment was done by the veterinarian. Farms reporting the practice of feeding the cows to increase their weight during the dry period had increased odds of ketosis.

Abomasum↗

PubMed1997

Effects of parenteral administration of vitamin E on health of periparturient dairy cows.

OBJECTIVE: To determine the effect of administration of vitamin E (D-alpha-tocopherol) on the incidence of retained placenta, metritis, and clinical mastitis during early lactation and on tocopherol concentrations. DESIGN: Prospective randomized controlled study. ANIMALS: 420 Holstein cows. PROCEDURE: Vitamin E (3,000 mg, IM, once) was administered to 204 cows B to 14 days before expected parturition, and 216 control cows were not treated. The number of cows that had retained placenta, metritis, clinical mastitis, displaced abomasum, and clinically apparent acetonemia or hypocalcemia were recorded. Serum concentrations of tocopherol, the tocopherol:cholesterol ratio, and glutathione-peroxidase activity were determined from samples obtained before administration of vitamin E, 7 and 14 days after administration, and at 30 days after parturition from 36 treated and 36 control cows. RESULTS: Administration of vitamin E significantly decreased the incidence of retained placenta and metritis (13/204 [6.4%] and 8/204: [3.9%], respectively, for the vitamin E-treated group; 27/216 [12.5%] and 19/ 216 [8.8%], respectively, for the untreated group) but did not affect the incidence of clinical mastitis. Serum vitamin E concentration was significantly higher in treated than in control cattle at 7 and 14 days after administration, but serum tocopherol: cholesterol ratio was significantly higher only at 7 days after administration. CLINICAL IMPLICATIONS: Parenteral administration of a single injection of vitamin E before parturition may decrease the incidence of retained placenta and metritis in dairy cows but will increase serum concentrations for 7 to 14 days after administration.

Animals↗

PubMed1996

Effects of porcine relaxin on induced parturition in beef heifers.

Two-year-old crossbred beef heifers were used to test the effects of porcine relaxin (pRelaxin) alone, or in combination with dexamethasone, on the induction of parturition, the incidence of dystocia, and retained placentas. Effects of treatment on pelvic area, postpartum interval, milk production, colostrum quality, calf birth weight, calf vigor, and calf performance were also evaluated. On Day 275 of gestation, heifers from two fetal-sire groups were randomly assigned to one of four groups in a 2 x 2 factorial design and received; no treatment (controls, n = 19), 20 mg of dexamethasone intramuscularly (im) (n = 22), 5 mg of pRelaxin (3,000 U/mg) im (n = 19), or 20 mg of dexamethasone plus 5 mg of pRelaxin (n = 17). Length of gestation (in days) was less (P < 0.05) in heifers treated with dexamethasone (279.8 +/- 1.0) than in controls (286.6 +/- 0.9), but was not influenced (P > 0.05) by treatment with pRelaxin. The incidence of retained placentas in heifers treated only with dexamethasone (27.3%) was not reduced by concomitant treatment with pRelaxin (35.3%). Retained placentas were not observed in any control heifers and in only one heifer (5.2%) treated solely with pRelaxin. Ease of calving (1 = unassisted, 5 = abnormal presentation) was not influenced by treatment (P > 0.05), even though birth weights (in kilograms) of calves from heifers treated with dexamethasone (36.4 +/- 0.8) were less (P < .01) than those of calves from nondexa-methasone-treated heifers (39.2 +/- 0.8). Dexamethasone tended to reduce (P < 0.07) calf vigor (1 = healthy and strong, 5 = dead on arrival; 1.48 +/- 0.11 vs. 1.18 +/- 0.11), but was not (P > 0.05) influenced by pRelaxin. The duration of the postpartum anestrous interval (73.1 +/- 1.8 d across groups) and pelvic areas following treatment and parturition were not influenced (P > 0.05) by dexamethasone or pRelaxin. Although determinants of colostrum quality (P < 0.01) and quantity (P < 0.08) of milk produced were influenced by dexamethasone, adjusted 205-d weights of calves did not differ (P > 0.05) among groups. In conclusion, treatment with pRelaxin alone failed to induce parturition or, when combined with dexamethasone, to reduce the incidence of retained placentas.

Animals↗

PubMed1998

Genetic parameters of health disorders, and relationships with 305-day milk yield and conformation traits of registered Holstein cows.

A total of 4368 first lactation records for Holstein cows from 30 herds was used to estimate genetic parameters for yield, conformation traits, and the binary coded disease traits of udder edema, milk fever, retained placenta, metritis, displaced abomasum, ketosis, cystic ovary, mastitis, and lameness. Data on health, parentage, and yield came from an on-farm program for record keeping and management. Test day production data were obtained from British Columbia DHI. Type classification data were received from the Holstein Association of Canada. Heritabilities of disease traits were low ranging from 0 to 0.05. Exceptions were lameness (0.16) and ketosis (0.39). Correlations of disease traits with 305-d milk yield and of selected type traits with retained placenta, displaced abomasum, mastitis, and lameness were estimated. Phenotypic correlations did not substantially differ from 0 except for the correlation between lameness and rear leg set (0.37). Genetic correlations between disease traits and milk yield were mostly positive (0.02 to 0.44). Only retained placenta had a negative genetic correlation with milk yield (-0.28). Genetic correlations ranged from 0 to 0.37 between udder conformation traits and mastitis, from -0.38 to 0.09 between leg conformation traits and lameness, and from -0.11 to 0.38 between rump conformation and retained placenta. The results suggest that selection based solely on yield may increase the incidence of disease. Selection on conformation traits can help reduce the incidence of disease, although genetic correlations are low.

Abomasum↗

PubMed2002

The effect of prepartum injection of vitamin E on health in transition dairy cows.

The objective of this study was to investigate parenteral vitamin E for the prevention of peripartum disease in dairy cows. A randomized clinical trial was conducted in 21 commercial dairy herds. Cows (n = 1142) were randomly assigned to receive either a single subcutaneous injection of 3000 IU of vitamin E, or placebo, 1 wk before expected calving. Serum alpha-tocopherol was significantly increased in treated cows at 7 and 14 d, but not at 21 d after injection. Overall, there were no significant differences between treatment groups in the incidence of retained placenta, clinical mastitis, metritis, endometritis, ketosis, displaced abomasum, or lameness. However, there was a conditional benefit of treatment for reduction of the incidence of retained placenta. Cows with marginal pretreatment vitamin E status (serum alpha-tocopherol to cholesterol mass ratio < 2.5 x 10(-3)) that received an injection of vitamin E tended to have reduced risk of retained placenta. However, in cows with adequate serum vitamin E, there was no reduction in the incidence of any disease. For clinical application, primiparous animals were most likely to benefit from prepartum injection of vitamin E.

Animals↗

PubMed2004

Changes in interleukin-6 concentration in peripheral blood of pre- and post-partum dairy cattle and its relationship to postpartum reproductive diseases.

Reproductive diseases after parturition are a serious problem in dairy cattle. It is important to predict postpartum reproductive diseases early and to develop prophylaxis. The objectives of this study were to demonstrate changes in the peripheral blood concentration of interleukin-6 (IL-6) before parturition, which was mainly produced by T helper 2 type (Th2) cells, and to investigate a correlation between the IL-6 concentration and the occurrence of the postpartum retained placenta, endometritis and/or follicular cyst in dairy cattle. Twenty-seven Holstein-Friesian cows were used for this study. Thirteen had no clinical disease, 8 had retained placenta, 4 were diagnosed with endometritis by vaginal inspection, and 2 were diagnosed with follicular cyst by rectal palpation at 1 and 2 months after parturition. Blood samples were collected 60 days pre- and post-partum. They used for IL-6, progesterone (P(4)) and estradiol-17beta (E(2)) concentration determination. This study showed that the IL-6 concentration prepartum was higher than postpartum. Low levels of IL-6 and P(4) in peripheral blood prepartum tended to affect retained placenta and a high level of IL-6 prepartum tended to affect endometritis. These results indicate that measurement of change in the IL-6 concentration during pregnancy is one useful tool for predicting crisis in postpartum reproductive diseases in dairy cattle.

Animals↗

PubMed1985

Path analysis of dry period nutrition, postpartum metabolic and reproductive disorders, and mastitis in Holstein cows.

Path analysis and logistic regression were used to model direct and indirect relationships among clinical periparturient (within 30 d after calving) retained placenta, metritis, veterinary-assisted dystocia, uncomplicated and complicated ketosis, left displaced abomasum, parturient paresis, mastitis, and estimated nutrient intakes (protein, calcium, phosphorus, energy; coded into terciles) in the last 3 wk of the dry period. Data were from 1,374 multiparous Holstein lactations for calvings from March 1981 through February 1982 in 31 commercial herds in central New York. Periparturient disorders occurred as a complex. Odds ratios for the multiplicative effects of parturient paresis on incidence of veterinary-assisted dystocia, retained placenta, complicated ketosis, and clinical mastitis were 7.2, 4.0, 23.6, and 5.4, respectively. Reproductive disorders were interrelated. Retained placenta, left displaced abomasum, and parturient paresis directly increased risk of complicated ketosis (odds ratios were 16.4, 53.5, and 23.6, respectively). Higher terciles of estimated energy intake in the last 3 wk of the dry period decreased risk of veterinary-assisted dystocia and left displaced abomasum, while higher terciles of estimated protein intake decreased risk of retained placenta and uncomplicated ketosis. Estimated nutrient intakes were directly related to subsequent metabolic disorders and directly and indirectly related (mediated by metabolic disorders) to reproductive disorders. The study suggests that feeding higher intakes (relative to National Research Council recommendations) of protein and energy in the last 3 week of the dry period may reduce the incidence of metabolic and reproductive disorders. Exact recommendations as to the amounts and types of feed cannot be made from our results.

Animal Nutritional Physiological Phenomena↗

PubMed1995

[Practice-oriented approach to secondary retention in cattle].

Veterinary practice research carried out from 1983 to 1986 showed that the incidence of retained placenta in cows decreased from 13.6% in 1983 to 9% in 1986. A possible relationship with the use of Holstein-Friesian breed during this period has been mentioned but not substantiated. Detailed data were collected for 503 cows treated for retained placenta with the aim of gaining insight into the cause of the problem. The data showed that there are two types of retained placenta (1). The type that cannot be 'peeled off', which occurs in animals that have given birth unexpectedly and too early and in cattle that calved unexpectedly after a normal or extended gestation; and (2) the type that can be 'peeled off', which occurs in animals with a normal parturition after a normal or extended gestation. Some cows were fed silage in the last month of gestation; 67% was of moderate-to-poor quality and 37% was of good quality.

Animal Feed↗

PubMed1991

Genetic analysis of reproductive disorders in Israeli Holstein dairy cows.

The heritability of common reproductive disorders was asessed in Israeli Holstein cows. Data were collected from 76,000 calvings on 102 collective farms (kibbuts) over a 36-mo period. The disorders considered were those of retained placenta, abnormal lochia, endometritis, anestrus, ovarian cysts with anestrus and ovarian cysts with nymphomania. The statistical model included fixed effects of herd-year, month of calving, duration of previous pregnancy, interaction between calving difficulty and sex of offspring, and the random effect of the sire. Herd-year effects consituted 0.68 of the explained variance of the incidence of retained placenta and approximately 0.89 of all the other disorders. Sire and calving-month effects were significant (P<0.05) for all the disorders. Heritability estimates of the disorders were 0.01 for retained placenta, abnormal lochia, and endometritis; 0.02 for anestrus; and 0.03 for all disorders. Correlations between any two disorders did not exceed 0.20. High genetic correlations were found between retained placenta and either abnormal lochia (0.90) or endometritis (0.70), while moderate genetic correlations were found among each of these and anestrus (0.30). Reproductive disorders occur as part of a complex which may be efficiently controlled by management measures. Nevertheless, breeding for resistance to reproductive disorders may also be feasible by using appropriate sires evaluated on a large number of daughters.

Journal Article↗

PubMed1998

Retrospective follow-up of maternal deaths and their associated risk factors in a rural district of Tanzania.

OBJECTIVE: To determine the maternal mortality rate in a rural district of Tanzania and to measure the incidence of causes of maternal mortality, the presence of risk factors and the relationship with social and demographic factors. METHOD: From January to December 1993 a retrospective recording of maternal deaths was completed using verbal autopsy and networking. RESULTS: A total of 76 deaths were found which is equivalent to a maternal mortality ratio of 961 per 100,000 live births for this 12-month period of time. The leading causes of death were postpartum haemorrhage with retained placenta, anaemia, postpartum haemorrhage without retained placenta, AIDS complex and obstructed labour (in descending order of frequency). Maternal deaths were seen irrespective of group factors such as access to a main road, presence of antenatal risk factors and contact with health care personnel or a nearby facility before death. Mortality was also present both in home and hospital deliveries (excluding hospital referrals). Antenatal care had been received by 97.2% of the mothers who died after the second trimester. The referral rate even in the presence of a known antenatal risk factor was 34.6%. Patient compliance to the referral was only 44.4%. Mothers and their families followed strong cultural beliefs even when they were detrimental to the mother's health. Maternal deaths were proportionately higher among women > 40 who were also gravid > or = 5, but there was no significant increase in deaths in women < 19 years of age. CONCLUSION: Effective antenatal care, appropriate emergency treatment of complications, access to transportation and competent referral level care with adequate equipment encompass the most effective answers to reduction of maternal deaths at a district level.

Adolescent↗

PubMed2004

Peripartum serum vitamin E, retinol, and beta-carotene in dairy cattle and their associations with disease.

Peripartum decreases in serum concentrations of vitamins A and E may contribute to impaired immune function in dairy cows. The objectives of this study were to describe peripartum serum concentrations of alpha-tocopherol, beta-carotene, and retinol and their associations with disease risk. On 20 farms over 1 yr, blood samples were collected weekly from 1057 cows from 1 wk before expected calving until 1 wk postpartum. Serum concentrations of alpha-tocopherol, beta-carotene, and retinol, as well as several biochemical variables were measured. Their associations with the risk of retained placenta or clinical mastitis were modeled separately with logistic regression, and the factors associated with the concentration of each vitamin were modelled with mixed linear regression. Differences in vitamin concentrations between 2 batches of sera analyzed 6 mo apart required stratification of statistical analyses. Accounting for the effects of parity, season, and twins, an increase in alpha-tocopherol of 1 microg/mL in the last week prepartum reduced the risk of retained placenta by 20%, whereas serum nonesterified fatty acid concentration > or = 0.5 mEq/L tended to increase risk of retained placenta by 80%. In the last week prepartum, a 100 ng/mL increase in serum retinol was associated with a 60% decrease in the risk of early lactation clinical mastitis. There were significant positive associations of peripartum serum concentrations among each of alpha-tocopherol, beta-carotene, and retinol.

Animals↗

PubMed2006

[Oxitocin trough umbilical vein to shorten the third stage of labor].

OBJECTIVE: To examine the efficacy and safety of oxitocin administered through umbilical vein after delivery to diminish the incidence of retained placenta, blood loss and third stage of labour. METHODOLOGY: A double blind, clinical trial was performed in which 64 women in labour, any age, with normal pregnancies, with gestational time between 37 to 42 weeks, were randomized to one of two groups. Group 1 received 10 UI of oxitocin (2 mL) diluted in 18 mL of saline solution through umbilical vein, immediately after delivery. Group 2 received only 20 mL of saline solution. Blood loss, time of third stage of labour, retained placenta, nausea, vomit and arterial hypotension were measured. RESULTS: Blood loss was 263.7 +/- 220.9 mL in group 1 (n=32) and 286.7 + 230.4 in group 2 (n=32) (p=0.68, Student T test). Time of third stage of labour was 265.3 +/- 383.9 seconds in group 1 and 197.1 +/- 314.3 in group 2 (p=0.44, Student T test). There was one retained placenta in group 1 and two in group 2 (RR 0.5 IC 0.04 a 5.24). There were not side effects in any group. CONCLUSIONS: Oxitocin trough umbilical vein immediately after delivery was not useful to diminish blood loss, retained placenta or time of third stage of labour.

Adult↗