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An observational cohort study of 3 units versus 5 units slow intravenous bolus oxytocin in women undergoing elective caesarean delivery


Terblanche, N and Otahal, P and Messmer, A and Wright, P and Patel, S and Nathan, K and Sharman, JE, An observational cohort study of 3 units versus 5 units slow intravenous bolus oxytocin in women undergoing elective caesarean delivery, Journal of Physiology and Pharmacology, 68, (4) pp. 547-553. ISSN 0867-5910 (2017) [Refereed Article]

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Copyright 2017 Journal of Physiology and Pharmacology

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This study sought to compare postpartum blood loss and maternal outcomes after 3IU and 5IU oxytocin at elective caesarean delivery. In a prospective observational study, 73 women undergoing elective caesarean delivery under spinal anaesthetic received a slow I.V. injection of either 3IU (n = 35) or 5IU (n = 38) oxytocin after delivery. The main outcome was gravimetrically measured 24-hour postpartum blood loss with a non-inferiority margin of 300 mL. Uterine tone, phenylephrine dose, emesis and hypotension after oxytocin administration were secondary outcomes. Gravimetric postpartum blood loss was lower in the 3IU group (-58.8 mL [95% CI: -212.1, 94.3]) after adjusting for BMI, pre-delivery vasopressor dose, parity, and risk of uterine atony, with the upper confidence limit below the 300 mL margin in support of non-inferiority. Patients receiving 3IU had a higher (non-significant) rate of having post-delivery phenylephrine to treat hypotension (RR = 1.59 [95% CI: 0.97, 2.63]), but of those treated, the 3IU group required significantly less (-427 mcg [95% CI: -740, -114]). The 3IU group had a lower prevalence of vomiting compared to those receiving 5IU (6% versus 24%; P = 0.047). Administration of 3IU oxytocin was non-inferior compared to standard 5IU with respect to blood loss in women undergoing elective caesarean delivery.

Item Details

Item Type:Refereed Article
Keywords:caesarean section, childbirth, oxytocin, postpartum haemorrhage, vasoconstrictor agents, vomiting, uterus
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Terblanche, N (Dr Nico Terblanche)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:124298
Year Published:2017
Web of Science® Times Cited:2
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-02-16
Last Modified:2018-07-20

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