Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: During the first hours that follow the birth of the baby (third and fourth stages of labor), complications are common and can threaten the mother's life. The most common complication is postpartum hemorrhage (PPH), which remains a leading cause of maternal mortality (25.0%) especially in developing countries .Three to five percent of deliveries are complicated by PPH and is 50 times more common in developing countries. Retained placenta is an another complication of third stage of labor. It complicates 0.1-2 % of deliveries . Without prompt treatment, women are at high risk of hemorrhage. At present, treatment is by manual removal of placenta, which needs an operating theatre, a surgeon, and an anaesthetist-facilities that are often unavailable to women in resource-poor settings. As a result, this condition has a case fatality rate of nearly 10% in rural communities.

The length of the third stage of labor, and its subsequent complications depends on a combination of the length of time it takes for placental separation and the ability of the uterine muscle to contract. Principal management of the third stage of labor is aimed at reducing the time of delivery of placenta so minimising serious adverse effects, such as blood loss and retained placenta. Active management of the third stage of labor, which includes prophylactic injection of 10 units of oxytocin within two minutes of birth, early clamping of the umbilical cord and controlled cord traction (CCT), is recommended by WHO for PPH prevention .

Umbilical vein oxytocin injection directs the treatment to the placental bed and uterine wall, resulting in an earlier uterine contraction and placental separation. However, very limited published literature is available, which evaluated the effect of umbilical vein oxytocin injection in routine practices for active management of the third stage of labor. The purpose of this investigation was to find out the beneficial effect of adding intraumbilical vein oxytocin in reducing the blood loss during third and fourth stages of labor, length of third stage of labor, and reduction in the incidence of manual removal of retained placenta.


Options:
A: Inclusion Criteria:

* gestational age between 37 and 42 weeks
* singleton pregnancy
* live fetus
* cephalic presentation
* neonatal birth weight of 2500-4500 g
* parity between one and five
* maternal age \< 35 years
* vaginal birth

Exclusion Criteria:

* blood pressure ≥ 140/90mmHg
* placenta previa
* placental abruption
* a history of any bleeding during pregnancy
* a history of curettage
* cesarean section or any uterine scar
* a history of postpartum hemorrhage
* polyhydramnios
* signs or symptoms of maternal infection
* known uterine anomalies
* history of any drug use during labor
* abnormal placentation)
* coagulation defects
* instrumental deliveries
* hemoglobin concentration \< 8 g/dL
* history of anticoagulant drugs
* beta-mimetic medications during pregnancy
* prolongation of the first stage of labor \> 15 hours.
B: Inclusion Criteria:

* Women\>18 years,
* during first stage of normal labor,
* at 36 to 42 weeks,
* with epidural analgesia and informed signed consent

Exclusion Criteria:

* Cesarean section delivery,
* clotting disorders,
* prostaglandin allergy,
* absent consent.
C: Inclusion Criteria:

* Study subjects will be women delivering via an elective cesarean section at term
* All study subjects will have singleton gestation with no obstetric or medical complication.

Exclusion Criteria:

* Laboring women
* Multifetal gestation
* Prolonged oxytocin use (\>12 hours)
* Hypertensive disorders
* Chorioamnionitis
* Suspected macrosomia
* Polyhydramnios
* History of postpartum Hemorrhage
* Clotting disorder
* Intake of magnesium sulfate
* Uterine fibroids
* Placenta previa
* Placental abruption
* Anticoagulation
D: Inclusion Criteria:

* having a singleton pregnancy above 37th gestational week
* normal live vaginal delivery with cephalic presentation
* being in active labor

Exclusion Criteria:

* Fetal demise
* multiple pregnancy
* known coagulation disorder
* presentation anomalies
* placental pathology
* liver disease
* thrombocytopenia
* hypertension or being currently on anticoagulants
* having a cesarean section, operative delivery or deep vaginal tear
* chorioamnionitis
* developing HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) or DIC (disseminated intravascular coagulation) before delivery

Answer: A