title: Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome.
abstract: OBJECTIVE
  Postpartum haemorrhage (PPH) represents a leading cause of maternal morbidity and mortality. Giving oxytocin after birth reduces the risk for PPH. It has never been tested whether different methods of oxytocin administration affect the maternal outcome. This study aims to compare the infusion versus the bolus application of oxytocin after singleton vaginal delivery.
  
  
  METHODS
  This retrospective monocentre study compares the incidence of clinically relevant postpartum complications in women receiving 5 IE of oxytocin as a bolus or as a 100 ml-infusion over 5 min, given immediately after birth. Included were women delivering singletons vaginally at term. We used propensity score weighting to compare outcomes between women receiving bolus and infusion and to minimize the selection bias in this retrospective cohort.
  
  
  RESULTS
  1765 patients were included. Patient characteristics were balanced. We found no significant differences for the combined overall postpartum adverse outcome (the incidence of PPH, manual removal of the placenta and/or curettage). For the single outcomes, we observed a significantly higher frequency of manual removal of the placenta (Odds ratio 1.47, 95 % CI 1.02-2.13) and a slightly higher but clinically not relevant estimated blood loss (Relative effect 1.05, 95 % CI 1.01-1.10) in the infusion group.
  
  
  CONCLUSIONS
  The data show a tendency towards more complications in the infusion group. It is related to a more frequent need for manual removal of the placenta.
authors.affiliation: Department of Obstetrics, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Julia J
authors.initials: JJ
authors.lastname: Löytved-Hardegg
authors.affiliation: Department of Obstetrics, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Brunner
authors.affiliation: Cantonal Hospital of Aarau, Women's Hospital, Tellstrasse, 5001, Aarau, Switzerland.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Ries
authors.affiliation: Clinical Trial Unit, University Hospital of Basel, Schanzenstrasse 55, 4031, Basel, Switzerland.
authors.forename: Stefanie
authors.initials: S
authors.lastname: von Felten
authors.affiliation: Department of Obstetrics, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Christina
authors.initials: C
authors.lastname: Heugel
authors.affiliation: Department of Obstetrics, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
authors.forename: Olav
authors.initials: O
authors.lastname: Lapaire
authors.affiliation: Hospital of Grabs, Women's Hospital, Spitalstrasse 44, 9472, Grabs, Switzerland.
authors.forename: Cora
authors.initials: C
authors.lastname: Voekt
authors.affiliation: Department of Obstetrics, University Hospital of Basel, Spitalstrasse 21, 4031, Basel, Switzerland. Irene.hoesli@usb.ch.
authors.forename: Irene
authors.initials: I
authors.lastname: Hösli
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007749:Labor Stage, Third; D007744:Obstetric Labor Complications / Q000453:epidemiology; D010120:Oxytocics / Q000008:administration & dosage; D010121:Oxytocin / Q000008:administration & dosage*; D018457:Placenta, Retained / Q000453:epidemiology / Q000628:therapy; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D049590:Postpartum Period; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D010120:Oxytocics; D010121:Oxytocin
keywords: Oxytocin; Post partum haemorrhage; Third stage of labour