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Am J Perinatol 2017; 34(4): 379-387
DOI: 10.1055/s-0036-1592130
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intravenous Oxytocin Use to Decrease Blood Loss during Scheduled Cesarean Delivery: A Randomized Double-Blinded Controlled Trial (OXYTRIAL)

Labib M. Ghulmiyyah
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Ihab M. Usta
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Ghina Ghazeeri
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Nael Taher
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Gael Abu-Ghannam
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
,
Hani Tamim
2   Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
,
Anwar H. Nassar
1   Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
› Author Affiliations
Further Information

Publication History

28 April 2016

30 July 2016

Publication Date:
02 September 2016 (online)

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Abstract

Objective The objective of this study was to determine the optimal dose of intravenous oxytocin administered during cesarean delivery (CD) to decrease the amount of blood loss.

Methods Out of a total of 226 women presenting for CD, 189 patients were randomized into three groups by a computer-generated random number sequence table. Low-risk women with singleton term pregnancies undergoing scheduled CD were assigned to receive 20, 30, or 40 units (U) of oxytocin diluted in 500 mL of lactated Ringer solution intraoperatively. The primary outcome was the change in hemoglobin from pre-CD to post-CD.

Results Overall, 63 women were assigned to each group. The primary outcome which was the drop in hemoglobin (1.4 ± 1.1 g/dL, 1.1 ± 0.8 g/dL, 1.0 ± 1.1 g/dL; p = 0.097) and the total calculated blood loss (798.6 ± 298.3 mL, 794.4 ± 313.5 mL, 820.2 ± 316.2 mL; p = 0.893) were not significantly different among the study groups. The incidence of intraoperative hypotension, postoperative systolic, and diastolic blood pressure changes was similar across the groups.

Conclusion The amount of blood loss during CD was not significantly different among the three groups, thus the lowest dose of oxytocin infusion (20 U in 500 mL of lactated Ringer solution) seems to be an appropriate regimen.

Keywords

uterine atony - oxytocin - blood loss - cesarean delivery

Clinical Trial Registration

This study is registered under ClinicalTrials.gov NCT00891150 available at: https://clinicaltrials.gov/ct2/show/NCT00891150?term=NCT00891150&rank=1.


 

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