Use of Prophylactic Oxytocin by Health Care Providers in Northeast Argentina As Part of Active Management of the Third Stage of Labor

Io reduce the incidence of post-partum hemorrhage, active management of the third stage of labor (AMTSL) has been widely recommended and accepted as standard care. In Argentina, AMTSL is not routinely practiced, largely because of lack of knowledge among health care providers and limited access to prophylactic uterotonics.

The primary objective was to measure and compare birth attendants’ knowledge regarding prophylactic uterotonics, controlled cord traction, and uterine massage from before and after the intervention. The secondary objective was to assess the availability and storage of prophylactic uterotonics at each of the participating hospitals.

This was a prospective study without a control group. The study took place in 5 public hospitals located throughout the province of Corrientes, an economically underdeveloped region of Argentina. 

30 providers participated in the baseline survey, and 32 providers participated in the follow-up study. During a 6-month baseline period, we performed an intervention consisting of training birth attendants on AMTSL, distributing oxytocin-filled vials of Uniject, and employing hospital reminders on practicing AMTSL. 

Information was collected from the study data forms of 941 women giving vaginal births at the baseline period and 951 at the intervention period.

In general, providers’ knowledge and positive attitude about AMTSL increased post-intervention. Post-intervention, nearly 97% of providers responded that they used Uniject to administer prophylactic uterotonic. 96% answered that Uniject facilitates the use of prophylactics as part of AMTSL. When Uniject to normal syringes, all contested that Uniject was easier to use. 44% replied that if Uniject was not available, oxytocin use would be reduced.

The results from our study indicate an overall increase in the use of AMTSL ensuing the intervention. The area that showed the greatest increase was the administration of prophylactic oxytocin. More health care workers in Corrientes Province are aware of AMTSL and how to administer each component.