Use of additional oxytocin to reduce blood loss at elective caesarean section A randomised control trial

GÜngÖrdÜk K., AŞICIOĞLU O., Celikkol O., Olgac Y., Ark C.

Australian and New Zealand Journal of Obstetrics and Gynaecology, cilt.50, sa.1, ss.36-39, 2010 (SCI-Expanded, Scopus)

Özet

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. © 2010 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.