title: Intravenous Oxytocin Use to Decrease Blood Loss during Scheduled Cesarean Delivery: A Randomized Double-Blinded Controlled Trial (OXYTRIAL).
abstract: ObjectiveThe 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.MethodsOut 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.ResultsOverall, 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.ConclusionThe 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.
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Labib M
authors: LM
authors: Ghulmiyyah
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Ihab M
authors: IM
authors: Usta
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Ghina
authors: G
authors: Ghazeeri
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Nael
authors: N
authors: Taher
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Gael
authors: G
authors: Abu-Ghannam
authors: Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Hani
authors: H
authors: Tamim
authors: Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
authors: Anwar H
authors: AH
authors: Nassar
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001794:Blood Pressure; D001810:Blood Volume; D002585:Cesarean Section / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications / Q000209:etiology / Q000517:prevention & control*; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D011184:Postoperative Period; D011247:Pregnancy
chemical_list: D006454:Hemoglobins; D010120:Oxytocics; D010121:Oxytocin