Oxytocin: IMA urges withdrawal of govt recommendation

According to gynecologists, prophylactic oxytocin is used to manage the third stage of labour to decrease the risk of excessive loss of blood after the delivery, also known as postpartum hemorrhage. The excessive loss of blood post-delivery can lead to the death of the mother but oxytocin helps to increase the uterine one and contractions, early umbilical cord clamping and facilitates placental delivery.

However, the Ministry of Health has given clinical guidelines to manage the third stage of labour stating that in all uncomplicated pregnancy, prophylactic oxytocin should not be administered immediately after the birth or with presentation of anterior shoulder at birth but only after the delivery of placenta. The guideline further stated that prophylactic oxytocin is to be given intramuscularly (directly into the muscle) to the mother only after placental delivery.

The Indian Medical Association stated that government has confused the two clinical procedures and government has nothing to do with the management of clinical situations. As per the WHO recommendations, the use of oxytocin helps in active management of third stage of labour and delayed cord clamping is recommended for all births to prevent childhood anaemia. WHO recommends delayed cord clamping for preterm babies and babies born to women living with HIV.

Thus, IMA general secretary Dr R V Asokan stated that IMA demands withdrawal of the recommendations as the role of prophylactic oxytocin and delayed clamping of the umbilical cord are two different procedures. He added that mothers are bound to die due to excessive bleeding after such a recommendation and held the government responsible for any such deaths.