Is placenta delivery with Syntometrine/Syntocinon a common practice in HK?

M

mariac

Registered User
Hello,

I am due to give birth in about 6 weeks at the Union Hospital in Shatin. My doctor is a resident doctor there. I recently went over my birth plan with her and while she has been mostly cooperative with the the drug-free natural approaches I am aiming for, she is not quite in agreement with the placenta delivery issue. She feels that rather than wait for the placenta to deliver naturally after delivery, it is better to take the Syntometrine/Syntocinon injection to help it to come out quickly. She feels that the injection reduces risk of placenta retention and heavy post-partum blood loss.

Now I am no doctor, but from everything I'm reading, it does not sound like taking the injection is a routine procedure unless there is already a lot of bleeding during labor/delivery. I also read that sometimes the injection can actually cause the placenta to be retained because the uterus clamps down too quickly. Not to mention that it's a drug and can have side effects such as nausea, headache and elevated blood pressure even.

Can anyone share if they have had any experiences with this procedure? If you have not given birth yet, is it something you have discussed with your doctor? How did that go? Any information is useful.

Thanks a lot!
 
i had my baby in queen mary hospital & was also going down the natural path. they were fine with the actual delivery being drug-free, but wanted to give a syntocin (i think) injection to speed things up immediately after delivery (well, close to, anyway). I was adament that they wait 30 minutes before doing this - i read somewhere that anything longer than about 30 minutes is getting a bit too long. they reluctantly agreed. i did end up having the injection because i hadn't delivered the placenta within the 30 minutes & they were worried about bleeding. I was fine with that, though, as they had respected my wish to let my body try first.

I recommend writing in your birth plan how long you would like to wait before receiving the injection & being firm about it in the delivery room.

good luck!
 
I had the injection (no other drugs prior or during delivery) and the placenta was delivered in about 20 minutes. It meant that I could then concentrate on my new baby much sooner!
 
I didn't have my babies in HK but know that in Australia it is standard practice in most hospitals to give the syntocin injection. Having said that i know people who have asked not to have it and their wishes been respected so it is possible, but i think takes a bit of effort, depending on the hospital and ob. It is definitely standard practice here in HK. As i unfortunately ended up having to have syntocin to be induced i decided it was not an issue despite wanting to avoid drugs as the syntocin was already in my system (they also waited 30 mins first at my request). I didn't notice any reaction at all.
 
Hi there, I had my baby in Australia, and even though my OB was very pro-natural, he recommends the delivery of the placenta with syntocinon. I had minimal bleeding, no reaction, and would definitely do the same again. Its pretty routine in Australia to give syntocinon to help placenta delivery, and I would think in Hong Kong too but I am not sure. Blood loss can cause some not-so-nice symptoms which will result in even more intervention. But if you really want to opt for drug-free, you can always try, then if there is bleeding you and your OB can make the call then to have the syntocinon? Good luck! :)
 
I declined the jab and wrote it in my birth plan. The didn't have any issue with me declining it. I gave birth in a public hospital.
 
Thanks ladies, for sharing your experiences. I'm going to modify my birth plan a little and suggest that some time be allowed to pass at least before giving me the injection. i think that's fair. but good to know that people who have taken it haven't had bad reactions to it.
 
Just a bit of info that might help with making a more informed decision - though your obstetrician should probably be giving you this info ....

The World Health Organisation recommends use of uterotonic (eg oxytocin) for active management in the third stage of labour - this has been associated with lower incidence of postpartum haemorrhage, less blood loss and reduced risk of blood transfusion.

http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd000007_abalose_com/en/index.html

Some trials have also shown reduced incidence of retained placenta (management for this if utertonics fail is manual removal - ie hand up your vagina and in the uterus to remove it! i don't know bout you but i'd like to avoid this at all costs!).

This Emedicine article has quite a good run down of the evidence based pros/cons and explanations for active management in the third stage of labour.

http://emedicine.medscape.com/article/275304-overview

Active management also considers early vs late cord clamping , and there is controversy over this with more research required. The WHO states that delayed cord clamping (1-3mins) may be beneficial for the baby, but only in the appropriate setting with skilled health-care providers. (i once heard a story of a homebirth where the couple wanted delayed cord clamping - the mother delivered on the floor, and after the baby was born the father was standing up and holding it up - obviously with gravity all the blood went from the baby to the placenta and baby got quite sick! a bit of common sense might have helped!).

WHO on timing of cord clamping:
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd004074_abalose_com/en/index.html

So obviously it's up to each individual what they want to do, but the general recommendations are to use oxytocin (i suppose there's a reason why it is considered "routine" in most institutions) and more research is required for timing of cord clamping.
 
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