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Use of additional oxytocin to reduce blood loss at elective caesarean section: A randomised control trial
Author(s) -
GÜNGÖRDÜK Kemal,
ASıCıOGLU Osman,
CELıKKOL Ozgu,
OLGAC Yusuf,
ARK Cemal
Publication year - 2010
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2009.01106.x
Subject(s) - medicine , uterotonic , oxytocin , bolus (digestion) , placebo , anesthesia , caesarean section , uterine atony , blood transfusion , relative risk , randomized controlled trial , adverse effect , confidence interval , pregnancy , obstetrics , surgery , hysterectomy , alternative medicine , pathology , biology , genetics
Objective: The purpose of this prospective, randomised, double‐blind, placebo‐controlled study was to assess the effects of a 5‐IU oxytocin bolus and placebo infusion versus a 5‐IU oxytocin bolus and 30 IU infusion on the control of blood loss at elective lower segment caesarean section (C/S). Methods: Participants with indication for elective C/S were randomly allocated to two groups. Group A, 360 women, received oxytocin 5 IU bolus and placebo; group B, 360 women received oxytocin 5 IU bolus and 30 IU infusion. Blood loss was estimated based on the haematocrit values before and 48 h after delivery. The primary outcome was the incidence of excessive bleeding (estimated blood loss of >1000 mL), while secondary outcomes included use of additional uterotonics, estimated blood loss, need for blood transfusion, duration of hospital stay and the incidence of adverse effects. Results: No demographic difference was observed between groups. Mean estimated blood loss ( P < 0.001) and the proportion of women with blood loss estimated to be greater than 1000 mL were significantly less for group B than for group A (relative risk (RR) 0.35, 95% confidence interval (CI) 0.20–0.63). In addition, more women in the group A required additional uterotonic agents (RR 0.35, 95% CI 0.22–0.56) and blood transfusion (RR 0.12, 95% CI 0.01–0.98). Conclusion: An additional oxytocin infusion after 5 IU oxytocin bolus infusion at elective C/S may reduce blood loss and required blood transfusion.