The active management of the 3rd stage of labour involves your caregiver administering an injection of an oxytocic drug (usually Syntocinon, but sometimes Syntometrine) into the mother's thigh or via her vein or a drip into her blood stream.
There are 2 commonly used combinations of oxytocic drugs used to routinely manage the 3rd stage. These in combination with another drug can be used to control excessive bleeding.
The drugs that may be used include:
Syntocinon
Ergometrine
Syntometrine
Syntocinon
Syntocinon is a synthetic form of the natural oxytocin produced by the woman's anterior pituitary gland in the brain. It is the same drug given to induce labour or augment a slow labour, but it is given in one injection into the woman's thigh and in a much higher dose for managing the 3rd stage (rather than in gradual, small doses through a drip in the vein when inducing or augmenting the labour).
Syntocinon was first produced in the 1950's and is usually given as a dose of 10 units (10 IU) in Australia. In the past 5 units (5 IU) was used but this was shown to be less effective and occasionally some caregivers preferred to give 5 IU with the birth of the baby's shoulder and another 5 IU after the baby or placenta were born (or 5 IU into the woman's thigh and a further 5IU into her vein). Having to give 2 injections was seen as fiddly and it is now rarely given this way.
Syntocinon is the first choice drug in Australia to routinely manage the 3rd stage of labour. It is effective, safer and produces fewer side effects than the other drug that can be used called Syntometrine. This is because Syntocinon closely mimics the woman's own natural oxytocin hormone stimulating shorter rhythmic contractions of the uterus.
Syntocinon makes the uterus contract within 2 to 3 minutes after being given as an intramuscular injection into the woman's thigh and will last up to 5 to 10 minutes.