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Trial registered on ANZCTR
Registration number
ACTRN12612000624886
Ethics application status
Approved
Date submitted
17/04/2012
Date registered
12/06/2012
Date last updated
12/06/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised controlled trial of intravenous versus intramuscular oxytocin in the management of third stage of labor.
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Scientific title
Intravenous versus intramuscular oxytocin in the management of third stage of labor for prevention of postpartum hemorrhage.
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Secondary ID [1]
280350
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nil
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Universal Trial Number (UTN)
nil
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Incidence of postpartum hemorrhage within 24 hours postpartum periods
286309
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Hematocrit concentration , change of hematocrit at 24 hr
286312
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Prolonged third stage of labor ( > 30 mins )
286313
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Oxytocin additional dose, other additional drugs
286314
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Blood transfusion
286315
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Condition category
Condition code
Reproductive Health and Childbirth
286554
286554
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0
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Normal pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm1: Intravenous oxytocin injection 10 units immediately after delivery of the newborn
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Intervention code [1]
284715
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Prevention
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Intervention code [2]
285042
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Treatment: Drugs
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Comparator / control treatment
Arm2: Intramuscular oxytocin injection 10 units immediately after delivery of the newborn
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Control group
Active
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Outcomes
Primary outcome [1]
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Incidence of postpartum hemorrhage within 24 hours postpartum periods using medical records
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Assessment method [1]
286985
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Timepoint [1]
286985
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at six months after randomization
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Secondary outcome [1]
297143
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Postpartum blood loss using medical records
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Assessment method [1]
297143
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Timepoint [1]
297143
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at six months after randomization
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Secondary outcome [2]
297144
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Hematocrit concentration , change of hematocrit at 24 hr using medical records
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Assessment method [2]
297144
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Timepoint [2]
297144
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at six months after randomization
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Secondary outcome [3]
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Prolonged third stage of labor morethan 30 minutes using medical records for the time from the delivery of the infant until delivery of the maternal placenta
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Assessment method [3]
297145
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Timepoint [3]
297145
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at six months after randomization
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Secondary outcome [4]
297146
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Oxytocin additional dose or other additional drugs requirement using medical records
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Assessment method [4]
297146
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Timepoint [4]
297146
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at six months after randomization
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Secondary outcome [5]
297147
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Amout of blood transfusion using medical records
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Assessment method [5]
297147
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Timepoint [5]
297147
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at six months after randomization
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Secondary outcome [6]
297148
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Adverse effect: hypotension during third stage of labor using medical records
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Assessment method [6]
297148
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Timepoint [6]
297148
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at six months after randomization
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Eligibility
Key inclusion criteria
. Singleton pregnancy with spontaneous vertex delivery
. Gestational age at least 34 weeks
. Parity < 5
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Minimum age
No limit
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
. Cesarean section
. High risk postpartum hemorrhage ;
- Pregnancy induced hypertension (PIH) ,
- multifetal pregnancy , polyhydramnios , macrosomia ,
- Placenta previa ,Placental abruption ,Placenta accreta/increta/percreta
- hematologic problems: thrombocytopenia, coagulopathy
- Obesity ( BMI >29 ) ,Previous postpartum hemorrhage
. Previous history of curettage
. Previous manual removal of placenta
. Cardiovascular instability
. Under anesthesia
. Oxytocin hypersensitivity
. Medical problem: Diabetes mellitus (DM) , nephrotic syndrome , renal insufficiency ,sepsis
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The randomization assignments were placed into opaque envelopes. Based on the obtained schedule, the number of sealed envelopes, which are equal to the required blocks, will be prepared and labeled. Each envelope contains the corresponding sealed allocation cards that will allocate treatments to patients. The people, who prepare the randomized scheme, will not involve in the trial. The allocation schedule will be concealed until the end of trial.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
After signing on the consent form, all eligible patients will be enrolled in the trial and then randomized by computer-generated randomization into two groups to receive intravenous oxytocin and intramuscular oxytocin in the management of the third stage of labor.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/06/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
450
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4266
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Thailand
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State/province [1]
4266
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Khon Kaen
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Funding & Sponsors
Funding source category [1]
285127
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Hospital
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Name [1]
285127
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Khon Kaen Hospital
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Address [1]
285127
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Srichan Road
Muang
Khon Kaen
40000
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Country [1]
285127
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Thailand
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Primary sponsor type
Hospital
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Name
Khon Kaen Hospital
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Address
Srichan Road
Muang
Khon Kaen
40000
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Country
Thailand
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Secondary sponsor category [1]
283990
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Individual
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Name [1]
283990
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Athittaya Krungpatee
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Address [1]
283990
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Srichan Road
Muang
Khon Kaen
40000
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Country [1]
283990
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Thailand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Khon Kaen Hospital Ethics committee
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Ethics committee address [1]
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Khon Kaen Hospital Srichan Road Muang Khin Kaen 40000
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Ethics committee country [1]
287143
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Thailand
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Date submitted for ethics approval [1]
287143
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Approval date [1]
287143
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Ethics approval number [1]
287143
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Summary
Brief summary
Postpartum hemorrhage (PPH) is a significant cause of maternal morbidity and mortality throughout the world especially in developing countries. Uterine atony is the most common etiology. The incidence of postpartum hemorrhage was 3.9% in women delivered vaginally. Active management in third stage of labor is accepted protocol to prevent postpartum hemorrhage. Active management in third stage of labour involves giving a prophylactic uterotonic drug, controlled cord traction to deliver the placenta and uterine massage. Routine oxytocin has been well established. Synthetic oxytocin, acts on the smooth muscle of the uterus to stimulate contractions; especially after term, when adequate oxytocin receptors. When oxytocin binds to oxytocin receptors induces increase intracellular Ca2+ releasing and the increased prostaglandin secretion all contribute to the contractile effects and inhibition of Gamma-Aminobutyric acid (GABA) receptors (this would depolarize if GABA acts as a tonic inhibitory modulator) also causes responses contractions of the uterus. Oxytocin use is advocated either intramuscularly (10 IU) or as a dilute infusion, intravenous bolus has also been used by other authors and they showed an IV bolus of oxytocin 5 to 10 IU, can be used for postpartum hemorrhage prevention after vaginal birth but is not recommended in case of elective cesarean section. At Khon Kaen Hospital guideline recommended 10 units intramuscular oxytocin for routine prophylaxis postpartum hemorrhage. The data of all deliveries in 2010 were collected .We found that postpartum hemorrhage rate 3 % follow vaginal delivery. No maternal death caused from postpartum hemorrhage . We therefore would like to conduct randomized controlled trial to compare the efficacy and safety of intravenous versus intramuscular oxytocin in the management of third stage of labor.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
34082
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Address
34082
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Country
34082
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Phone
34082
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Fax
34082
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Email
34082
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Contact person for public queries
Name
17329
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Athittaya Kruangpatee
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Address
17329
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Khon Kaen Hospital
Srichan Road
Muang
Khon Kaen
40000
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Country
17329
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Thailand
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Phone
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+6643336789 ext 3736
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Fax
17329
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+6643336789 ext 3736
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Email
17329
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[email protected]
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Contact person for scientific queries
Name
8257
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Ussanee Sangkhomkhamhang
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Address
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Khon Kaen Hospital
Srichan Road
Muang
Khon Kaen
40000
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Country
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Thailand
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Phone
8257
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+6643336789 ext 3736
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Fax
8257
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+6643336789 ext 3736
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Email
8257
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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