Effectiveness of Intramuscular Oxytocin in managing the third stage of labour among women delivering at regional referral hospitals in Dar es Salaam, Tanzania
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Date
2025
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Kairuki University
Abstract
Introduction: Postpartum hemorrhage (PPH) is a significant cause of maternal mortality, particularly in developing countries, accounting for around 25% of maternal deaths globally. Intramuscular oxytocin is a common intervention for PPH. It is
influenced by factors such as maternal anaemia, demographics, and medical history. This study evaluates the incidence of PPH, hemoglobin changes, maternal outcomes, and the impact of maternal factors on oxytocin effectiveness in prevention of PPH in
Dar es Salaam regional referral hospitals.
Objective: To evaluate the effectiveness of intramuscular oxytocin in managing the third stage of labour and its impact on maternal outcomes among women delivering at regional referral hospitals in Dar es Salaam, Tanzania.
Methodology: This cohort study was conducted at three regional referral hospitals in Dar es Salaam, Tanzania, from February to June 2024, involving 288 term pregnant women in active labour. The primary depended variable was incidence of PPH. Stratified random sampling was utilized, and data collection was performed using a questionnaire. Data analysis was conducted using SPSS version 25.descriptive statistics was used to summarize the incidence of PPH and maternal complication. The paired and upaired T-test was used to evaluate hemoglobin change.Chi-square test and multivalient logist regession were used for association of anaemia with PPH. The adjusted odds ratios (aOR), 95% confidence intervals (CI), and p-values were used to quantify the strength and significance of associations, with statistical significance set at p ≤ 0. 05.
Results: The study analyzed 288 women, with the majority from Temeke Regional Referral Hospital (TRRH) 129 (44.8%), Amana Regional Referral Hospital (ARRH) 115 (39.9%), and Mwananyamala Regional Referral Hospital (MRRH) 44 (15.3%). Among the cohort, 185 (64.2%) were anaemic (Hb < 11 mg/dL), and the occurrences of PPH were found to be 51 patients with cumulative incidence of 17.1%. Among those with postpartum haemorrhage, 48 (94.1%) were anaemic, 41 (80.4%) had tachycardia, 38 (74.5%) had clammy skin, 36 (72.5%) experienced pubic swelling, 30 (58.8%) reported dizziness, and 26 (51.0%) had fever. Women aged 35 years and above had significantly higher odds of postpartum haemorrhage compared to those under 35 (aOR = 6.11, 95% CI: 2.66–14.03, p < 0.001). Not taking haematinics was associated with increased odds of postpartum haemorrhage (aOR = 2.14, 95% CI: 1.04–4.39, p = 0.039), while having no history of bleeding (aOR = 0.44, 95% CI: 0.21–0.90, p = 0.024) and being non-anaemic (aOR = 0.11, 95% CI: 0.03–0.40, p = 0.001) were protective factors.
Conclusion: Despite the routine use of intramuscular oxytocin for PPH prevention, its incidence remains significant (17.1%). This highlights the importance of addressing contributing factors such as maternal anaemia, advanced maternal age, lack of hematinic use, and a history of bleeding. While intramuscular oxytocin is recognized as a key intervention for uterine contraction and haemorrhage control.
Description
Dissertation submitted to the School of Medicine in partial fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology of Kairuki University
Keywords
anaemia, trimester, postpartum hemorrhage
Citation
Bizeze, Rudovick B., 2025. Effectiveness of Intramuscular Oxytocin in managing the third stage of labour among women delivering at regional referral hospitals in Dar es Salaam, dissertation. Kairuki University