title: Higher-dose oxytocin to prevent obstetric hemorrhage at vaginal delivery-does duration of infusion matter?
abstract: OBJECTIVE
  Postpartum higher-dose oxytocin (80 U) compared with lower dose (10 U) given in 500 mL over 1 hour does not decrease postpartum hemorrhage (PPH) requiring treatment, but reduces the risk of hematocrit decline ≥ 6% among women delivering vaginally. Our objective was to evaluate whether the duration of administration of oxytocin influences outcomes.
  
  
  METHODS
  We compared a cohort receiving a postpartum oxytocin infusion of 80 U/500 mL over 1 hour to a concurrent cohort of women receiving 80 U/500 mL over 8 hours. The primary outcome was any treatment of PPH (uterotonics, blood transfusion, tamponade, and surgery). Secondary outcomes included pre- to postdelivery median hematocrit change and hematocrit decline ≥ 6%.
  
  
  RESULTS
  There were 653 and 676 women identified in the 1- and 8-hour cohorts, respectively. There was no difference in PPH requiring any treatment between the 1- and 8-hour cohorts (6 vs. 6%, p = 0.70). There were no differences in individual treatment components including blood transfusion (p = 0.75). Median hematocrit decline (p = 0.02) was lower in the 8-hour cohort, but there was no difference in frequency of hematocrit decline ≥ 6% (p = 0.15). Results were unchanged by multivariable adjustments.
  
  
  CONCLUSIONS
  Postpartum higher-dose oxytocin administered over 1 hour compared with 8 hours was not associated with an increased treatment of PPH or frequency of hematocrit decline ≥ 6%.
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Akila
authors.initials: A
authors.lastname: Subramaniam
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Adi R
authors.initials: AR
authors.lastname: Abramovici
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Jeffery M
authors.initials: JM
authors.lastname: Szychowski
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Michelle
authors.initials: M
authors.lastname: Roach
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: John
authors.initials: J
authors.lastname: Owen
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
authors.affiliation: Department of Obstetrics and Gynecology, Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Alan T N
authors.initials: AT
authors.lastname: Tita
mesh_terms: D000328:Adult; D005260:Female; D006400:Hematocrit; D006801:Humans; D010121:Oxytocin / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000503:physiopathology / Q000517:prevention & control*; D011247:Pregnancy; D014590:Uterine Contraction / Q000502:physiology; D055815:Young Adult
chemical_list: D010121:Oxytocin