What is it used for?
- Helping to deliver the placenta in the last stage of labour.
- Preventing or controlling heavy bleeding after delivery of the placenta (post-partum haemorrhage).
How does it work?
Syntometrine injection contains two active ingredients, ergometrine and oxytocin.
Ergometrine is a type of medicine called an ergot alkaloid. It acts on receptors found on the uterus (womb), causing the uterus to contract.
The oxytocin in the injection is the same as the natural hormone. Oxytocin is normally released by the pituitary gland in the brain towards the end of pregnancy to stimulate the uterus to contract during labour, so that the baby can be pushed out. The man-made oxytocin in this injection has the same effect on the womb.
The combination of synthetic oxytocin and ergometrine in Syntometrine can be given to manage the third stage of labour. The injection is given just after the birth of the baby to stimulate the womb to contract. This helps the placenta to separate from the womb and be pushed out, speeds up delivery of the placenta and reduces the risk of heavy bleeding.
The injection may also be given after the placenta has been delivered, in order to prevent or control excessive bleeding.
How is it given?
- To help deliver the placenta, one injection is given into the muscle of your thigh, either as the baby's shoulder is delivered or immediately after the baby has been delivered.
- To help prevent or control bleeding, one injection is given into the muscle of your thigh, either just after the placenta has been delivered or when bleeding occurs.
- The injection may occasionally be given into a vein instead of muscle if bleeding is very severe, but this is not usually recommended.
Not to be used in
- Inducing labour or the first stage of labour.
- The second stage of labour before the baby's shoulder can be seen.
- Women whose womb is not contracting normally during labour.
- Women with very high blood pressure (severe hypertension).
- Women with pre-eclampsia or eclampsia.
- Women with severe heart, liver or kidney disorders.
- Women who have problems with poor blood circulation (vascular disease).
- Women with a severe infection (sepsis).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or midewife if you have previously experienced such an allergy.
If you feel you have experienced an allergic reaction after having this injection inform your doctor or midwife immediately.
Use with caution in
- Women with decreased kidney or liver function.
- Women with heart disease.
- Women with mildly raised blood pressure (hypertension).
- Inherited blood disorders called porphyrias.
Pregnancy and breastfeeding
Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
- This medicine is widely used to manage the third stage of labour and to control blood loss following delivery. It should not be used at any other point during pregnancy.
- The ergometrine and oxytocin in this injection can both pass into breast milk, but this should not have any harmful effects on the newborn baby. Oxytocin is a normal component of breast milk and ergometrine is unlikely to be harmful to the baby because it is inactivated in the baby's gut.
- Ergometrine can reduce production of breast milk, although problems with breastfeeding are unlikely after one injection. Repeated use of the injection should be avoided in mothers who are breastfeeding. Oxytocin is one of the hormones needed to produce breast milk.
Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people having this medicine will experience that or any side effect.
- Nausea and vomiting.
- Abdominal pain.
- Skin rashes.
- High blood pressure (hypertension).
- Chest pain.
- Abnormal heartbeats (arrhythmias).
- Shortness of breath.
The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?
Your doctor or midwife will make sure that all medicines given during labour are compatible. If you are already taking any medicines you should make sure your midwife is aware of this, so they can check that it is safe to give you other medicines as well.
Oxytocin and ergometrine increase the effect of prostaglandins (used to induce labour) on contractions of the womb and vice-versa. If you are given oxytocin after a prostaglandin your contractions should be carefully monitored.
This medicine may enhance the blood pressure raising effect of medicines that other medicines that can raise blood pressure by constricting blood vessels, for example nasal decongestants or triptans/ergot medicines for migraine.
This medicine may not be recommended if you are taking any of the following medicines, because these could reduce the breakdown of ergometrine by the liver and thus increase the risk of its side effects:
- azole antifungals, eg fluconazole, itraconazole
- macrolide antibiotics, eg erythromycin, clarithromycin, telithromycin
- protease inhibitors for HIV infection, eg ritonavir, atazanavir, darunavir
Other medicines containing the same active ingredients
There are currently no other medicines available in the UK that contain both oxytocin and ergometrine.
Syntocinon contains oxytocin alone.