A RANDOMIZED DOUBLE-BLIND COMPARISON OF SYNTOMETRINE(R) AND SYNTOCINON(R) IN THE MANAGEMENT OF THE 3RD STAGE OF LABOR

Objective To compare the effect of intramuscular Syntometrine and Synt ocinon in the management of the third stage of labour. Design A random ised double blind prospective study. Setting Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong. Subjects One tho usand consecutive patients with singleton pregnancy and vaginal delive ry in February and March 1993. Results The use of Syntometrine in the management of the third stage not only reduced the blood loss after de livery but was associated with a 40% reduction in the risk of postpart um haemorrhage (odds ratio 0.60; 95% CI 0.21-0.88), and the need for r epeat oxytocic injections (odds ratio of 0.63; 95% CI 0.44-0.89). The two drugs did not differ in their effect on the duration of the third stage. However, the incidence of manual removal of the placenta was hi gher when Syntometrine was used (odds ratio 3.7; 95% CI 1.03-12.5), al though the overall incidence remained low. Side effects from both drug s, such as nausea, vomiting, headache and hypertension, were uncommon. Conclusion Intramuscular Syntometrine is a better choice than Syntoci non in the management of the third stage of labour.