{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:32:13Z","timestamp":1783081933579,"version":"3.54.6"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the efficacy of different prophylactic oxytocin regimens in preventing postpartum hemorrhage (PPH) after vaginal delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Single\u2010center retrospective cohort study including all vaginal deliveries between February 1, 2022, and December 31, 2023, at a tertiary referral unit. Throughout the study period, the local protocol for PPH prevention in vaginal delivery was changed from oxytocin 10\u2009IU intramuscular injection (IM) to 5\u2009IU intravenous bolus (IV) and eventually to 10\u2009IU IV. Data regarding base maternal characteristics, pregnancy course, labor, and maternal outcomes were retrospectively collected from institutional labor ward registries. The incidence of PPH was compared among the three historical cohorts who received different oxytocin regimens (10\u2009IU IM, group A; 5\u2009IU IV, group B; and 10\u2009IU IV, group C) following propensity score matching for those variables that proved to be significantly associated with PPH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      During the study period, 3850 women had a vaginal birth at our tertiary care unit (1245 in the 10\u2009IU IM group, 1291 in the 5\u2009IU IV group and 1314 in the 10\u2009IU IV group) and were enrolled in the study population. Of these, 688 (17.8%) had PPH. At multivariable logistic regression nulliparity, second\u2010degree or higher perineal tears, episiotomy, manual placental removal, birth weight, and multiple gestation appeared to be independently associated with PPH. PPH incidence was then compared among the groups following 1:1 propensity score matching for the above cited factors and appeared significantly higher with the use of 10\u2009IU IM (group A) versus 5\u2009IU IV (group B) oxytocin (21.3% versus 11.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and versus 10\u2009IU IV (group C) (22.1% versus 16.8%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.033); non\u2010significant differences between the incidence of PPH were observed when comparing the two regimens of IV administration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Intravenous administration of 5\u2009IU or 10\u2009IU is more effective than IM administration of 10\u2009IU in reducing the incidence of PPH after vaginal deliveries. The efficacy of the two IV regimens appears similar.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70636","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:41:19Z","timestamp":1762324879000},"page":"379-385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative evaluation of prophylactic strategies for postpartum hemorrhage in vaginal delivery"],"prefix":"10.1002","volume":"173","author":[{"given":"Stefania","family":"Fieni","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0429-729X","authenticated-orcid":false,"given":"Giovanni","family":"Morganelli","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa","family":"Valenti","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debora","family":"Formisano","sequence":"additional","affiliation":[{"name":"Azienda Unit\u00e0 Sanitaria Locale\u2014IRCCS Tecnologie Avanzate e Modelli Assistenziali in Oncologia di Reggio Emilia  Reggio Emilia Emilia\u2010Romagna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella Maria","family":"Celora","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biancamaria","family":"Mastrandrea","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tullio","family":"Ghi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Parma  Parma Italy"},{"name":"Department of Women, Child and Public Health, Catholic University of Sacred Heart Rome Fondazione Policlinico Universitario Agostino Gemelli IRCCS  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"The WOMAN Trial (World Maternal Antifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemorrhage: an international randomised, double blind placebo controlled trial","volume":"11","author":"Shakur H","year":"2010","journal-title":"Rials"},{"key":"e_1_2_9_3_1","article-title":"Active versus expectant management for women in the third stage of labour","volume":"2","author":"Begley CM","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_4_1","article-title":"Intravenous versus intramuscular prophylactic oxytocin for the third stage of labour","volume":"11","author":"Oladapo OT","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_5_1","volume-title":"WHO Recommendations: Uterotonics for the Prevention of Postpartum Haemorrhage","author":"World Health Organization","year":"2018"},{"key":"e_1_2_9_6_1","unstructured":"National Guidelines System Istituto Superiore di Sanit\u00e0 (ISS).Postpartum Hemorrage: How to Prevent It How to Treat It.2016. Guideline 26.https:\/\/www.epicentro.iss.it\/itoss\/pdf\/SNLG_EPP\u20102016web_corrige.pdf"},{"key":"e_1_2_9_7_1","volume-title":"Prevention and Management of Postpartum Haemorrhage. Green\u2010Top Guideline No. 52","author":"Royal College of Obstetricians and Gynaecologists","year":"2016"},{"key":"e_1_2_9_8_1","volume-title":"Intrapartum Care. NICE Clinical Guideline 235","author":"National Institute for Health and Care Excellence","year":"2023"},{"issue":"4","key":"e_1_2_9_9_1","article-title":"Postpartum hemorrhage","volume":"130","author":"ACOG","year":"2017","journal-title":"ACOG Pract Bull"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.11.1298"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k3546"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e318242da74"},{"issue":"4","key":"e_1_2_9_13_1","article-title":"Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage","volume":"4","author":"Salati JA","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-2115(00)00311-0"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000148264.20909.bb"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14757"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijoa.2009.08.005"}],"container-title":["International Journal of Gynecology &amp; Obstetrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70636","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijgo.70636","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijgo.70636","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:23:15Z","timestamp":1776090195000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1002\/ijgo.70636"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/ijgo.70636"],"URL":"https:\/\/doi.org\/10.1002\/ijgo.70636","archive":["Portico"],"relation":{},"ISSN":["0020-7292","1879-3479"],"issn-type":[{"value":"0020-7292","type":"print"},{"value":"1879-3479","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"assertion":[{"value":"2025-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}