Introduction/Objective: To determine which of two commonly used oxytocic drugs for the active management of the third stage of labour is superior in terms of reducing postpartum haemorrhage (PPH).

Methods: A structured review of all randomized controlled trials of oxytocin vs. Syntometrine (ergometrine and oxytocin) when used as part of the routine active management of the third stage of labour.

Results: The review suggests a small reduction in the risk of PPH when using ergometrine-oxytocin, although this is not statistically significant for serious PPH (>1000ml). Furthermore this advantage is less marked when the dose of lOiu is used (compared to when the dose of 5iu was used). Syntometrine is, however, associated with more side effects, such as vomiting and hypertension (an ergometrine effect). No significant differences were found in other maternal outcomes nor for any of the neonatal outcomes assessed.

Discussion: The advantages of the small but significant reduction in blood loss need to be weighed against the more common disadvantages associated with the use of Syntometrine. Further clinical research concerning the optimal dose of oytocin needs to be undertaken.