Oxytocic Drugs in Fourth Stage of Labor

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Abstract
A group of 1,459 parturient women were the subjects of a controlled double-blind study assessing the effects of oxytocin, methylergonovine maleate, and a placebo upon the fourth stage of labor. Although patients in the placebo group had a higher incidence of hemorrhage and more often required additional treatment in the form of an oxytocic agent, 88% of this group had no difficulty. Methylergonovine maleate was the agent most effective in preventing postpartum hemorrhage. Postpartum blood pressure rises occurred in all three groups, most frequently following methylergonovine maleate and least often following a placebo. In patients with toxemia of pregnancy, methylergonovine maleate was associated with a high incidence of severe pressor responses. In patients with toxemia, if an oxytocic agent is required, oxytocin is the drug of choice.