Oxytocin timing with delayed cord clamping investigated for postpartum hemorrhage prevention

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality globally, often stemming from uterine atony. Despite the widespread use of oxytocin as the primary uterotonic for PPH prevention, uncertainties persist regarding its optimal administration strategy. High uterine blood flow at term necessitates rapid achievement of uterine tone to minimize blood loss, making precise timing critical. Current clinical practice often involves immediate oxytocin, but the increasing adoption of delayed cord clamping (DCC) introduces a variable that may influence the ideal timing of uterotonic delivery. The interplay between DCC and oxytocin timing is not fully understood, creating a gap in evidence-based protocols for managing the third stage of labor.

This research aims to determine the optimal timing for oxytocin administration in the context of delayed cord clamping (DCC) to reduce postpartum blood loss. The study compares two distinct timings: initiating oxytocin immediately after the baby is born versus after the placenta has delivered. This investigation seeks to clarify if one timing strategy is superior in decreasing the amount of blood lost following both vaginal and cesarean deliveries. The primary endpoint is the amount of blood lost after birth, with a focus on how this is affected by the sequence of oxytocin delivery relative to delayed cord clamping.