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


CONCLUSIONS
An additional oxytocin infusion after 5 IU oxytocin bolus infusion at elective C/S may reduce blood loss and required blood transfusion.
Güngördük
Kemal
K
Erzincan Military Hospital, Turkey. maidenkemal@yahoo.com
Asicioglu
Osman
O
Celikkol
Ozgu
O
Olgac
Yusuf
Y
Ark
Cemal
C
D000328:Adult; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007902:Length of Stay; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D010919:Placebos; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D055815:Young Adult
D010120:Oxytocics; D010919:Placebos; D010121:Oxytocin