An Australian and New Zealand survey of practice of the use of oxytocin at elective caesarean section.
BACKGROUND
The use of oxytocin to prevent postpartum haemorrhage at elective caesarean section is largely based on evidence derived from vaginal births. Overseas studies indicate wide variation in practice with regard to specific doses of oxytocin administered at caesarean section. No such surveys have been undertaken in Australia or New Zealand.


OBJECTIVE
To survey and report Australian and New Zealand practice regarding oxytocin administration at elective caesarean section.


METHODS
A structured questionnaire was posted to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists resident in Australia and New Zealand.


RESULTS
One thousand five hundred and forty-seven questionnaires were distributed, of which 890 (58%) were returned. Of these, 700 Fellows, 600 from Australia and 100 from New Zealand, currently practiced obstetrics. Almost all Fellows, 686 (98%), reported that they administered an oxytocin bolus at elective caesarean section, most commonly 10 IU (n = 460) or 5 IU (n = 220). The choice of bolus dose was related to country, duration and type (private or public) of practice. A majority of Fellows, 683 (98%), used an additional oxytocin infusion, either routinely or selectively. A total of 68 different regimens were reported. The single most common regimen was 40 IU oxytocin in 1000 mL administered over four hours, used by 255 Fellows (37%).


CONCLUSIONS
There are wide variations in the usage of oxytocin at elective caesarean section in Australia and New Zealand, most likely due to a lack of high level evidence to guide practice. Appropriately designed clinical trials are needed to provide evidence to support future practice.
Mockler
Joanne C
JC
Department of Obstetrics and Gynaecology, Monash Institute of Medical Research, Monash University, Australia.
Murphy
Deirdre J
DJ
Wallace
Euan M
EM
D001315:Australia; D002585:Cesarean Section; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D009520:New Zealand; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy
D010120:Oxytocics; D010121:Oxytocin