A reappraisal of the use of ergometrine

Abstract

Summary Syntometrine, a combination of ergometrine and oxytocin, is used almost universally in Great Britain at the end of the second stage of labour to reduce blood loss and prevent postpartum haemorrhage. In the United States of America, ergometrine has rarely if ever been used in recent years for this purpose as it is considered to be neither the safest nor the most effective drug for third stage management. A review of the literature suggests that the danger of ergometrine compared with oxytocin has been exaggerated. In a series of 2102 cases, Syntometrine has been compared with oxytocin. Intramuscular oxytocin is less effective in reducing postpartum blood loss than intramuscular Syntometrine. The treatment of choice is intravenous oxytocin, but there are practical difficulties in routinely giving an intravenous injection during the second stage of labour, unless the patient already has an intravenous dextrose drip. So, patients who have a drip running should be given intravenous oxytocin: those who have not, should be given intramuscular Syntometrine