A randomised double blind comparison of Syntometrine® and Syntocinon® in the management of the third stage of labour

OBJECTIVE: To compare the effect of intramuscular Syntometrine and Syntocinon in the management of the third stage of labour. DESIGN: A randomised double blind prospective study. SETTING: Department of Obstetrics and Gynaecology, Prince of Wales Hospital, Hong Kong. SUBJECTS: One thousand consecutive patients with singleton pregnancy and vaginal delivery in February and March 1993. RESULTS: The use of Syntometrine in the management of the third stage not only reduced the blood loss after delivery but was associated with a 40% reduction in the risk of postpartum haemorrhage (odds ratio 0.60; 95% CI 0.21-0.88), and the need for repeat 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 higher when Syntometrine was used (odds ratio 3.7; 95% CI 1.03-12.5), although the overall incidence remained low. Side effects from both drugs, such as nausea, vomiting, headache and hypertension, were uncommon. CONCLUSION: Intramuscular Syntometrine is a better choice than Syntocinon in the management of the third stage of labour.