Comparison of the effect of breast pump stimulation and oxytocin administration on the length of the third stage of labor, postpartum hemorrhage, and anemia: a randomized controlled trial

BMC Pregnancy Childbirth. 2018 Jul 7;18(1):293. doi: 10.1186/s12884-018-1832-z.

Abstract

Background: This study aimed to compare the effect of breast pump stimulation with that of oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, and anemia after delivery.

Methods: In this study, 108 women were randomly assigned to two groups of breast pump stimulation (n = 54) and oxytocin administration (n = 54). Women in the breast stimulation group received breast pump stimulation (10 min intermittently for each breast with a negative pressure of 250 mmHg), while the women in the oxytocin (control) group received an infusion of 30 IU oxytocin in 1000 mL of Ringer's serum with a maximum rate of 10 mL infusion per min after delivery. The duration of the third stage of labor, blood loss during the third stage of labor and 24 h after delivery, hemoglobin and hematocrit (before and 24 h after delivery), after-birth pain, and the number of breastfeedings during the 24 h after delivery were recorded. The data were analyzed using the chi-square test, independent t-test, and Wilcoxon test.

Results: The mean duration of the third stage was 5 ± 1.97 and 5.4 ± 2.5 min in the breast stimulation and women that received intravenous oxytocin respectively (p = 0.75). Most participants had mild postpartum hemorrhage (98.1 and 96.2% in the breast stimulation and women that received intravenous oxytocin, respectively, p = 0.99). Although hemoglobin and hematocrit levels significantly decreased in both groups 24 h after delivery, there was no significant difference between both groups regarding both parameters. After-birth pain was significantly lower and the number of breastfeeding during the 24 h after delivery was significantly more in the breast stimulation group compared to the control group.

Conclusions: Our results demonstrated no differences between breast pump stimulation and oxytocin administration regarding the duration of the third stage of labor, postpartum hemorrhage, anaemia, after-birth pain, and the number of breastfeedings during the 24 h after delivery.

Trial registration number: The study protocol was registered in the Iranian Randomized Controlled Trial Registry (Ref. No.: IRCT2015050722146N1 ; Registration date: 2015-11-04). The study was registered prospectively and the enrollment date was 23/8/2015.

Keywords: Breast stimulation; Hematocrit; Hemoglobin; Postpartum hemorrhage.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Adult
  • Anemia* / diagnosis
  • Anemia* / etiology
  • Breast Milk Expression / methods*
  • Female
  • Hematocrit / methods
  • Hemoglobins / analysis
  • Humans
  • Labor Stage, Third* / drug effects
  • Labor Stage, Third* / physiology
  • Obstetric Labor Complications* / diagnosis
  • Obstetric Labor Complications* / etiology
  • Obstetric Labor Complications* / prevention & control
  • Oxytocics / administration & dosage
  • Oxytocin / administration & dosage*
  • Postpartum Hemorrhage* / blood
  • Postpartum Hemorrhage* / diagnosis
  • Postpartum Hemorrhage* / prevention & control
  • Pregnancy
  • Treatment Outcome

Substances

  • Hemoglobins
  • Oxytocics
  • Oxytocin