Early versus Delayed Oxytocin Administration during Caesarean Section: A Randomized Controlled Clinical Trial

Abstract

Background: Cesarean delivery (CD) is commonly performed operation in modern obstetrics. The risks of cesarean section (CS) include maternal mortality, hemorrhage, venous thrombosis, infections, and anesthetic complications. Oxytocin is the most commonly used ecbolic agent during management of atonic postpartum hemorrhage. The aim of the current study was to compare between the influence of early IV oxytocin infusion early and the standard administration on intraoperative blood loss during caesarean section. Patients and methods: A randomized controlled clinical trial was conducted at Obstetrics and Gynecology Department of Mansoura University Hospitals. This clinical trial included women aged between 18 and 40 years old admitted for elective CS (low risk). The study population consisted of 80 women who were randomly divided into 2 groups. Intervention group included 40 women who received oxytocin infusion immediately after incision of pelvic peritoneum. Control group included 40 cases who received oxytocin after clamping the umbilical cord. Results: There was no significant difference between both groups in terms of primary post-partum hemorrhage or the need for blood transfusion. However, the mean intraoperative blood loss was significantly lower among females who received early oxytocin prior to uterine incision as compared to the control group who received oxytocin after fetal delivery. Conclusion:Early administration of oxytocin (before uterine incision) compared to late oxytocin (after clamping of umbilical cord) is associated with significantly lower mean intra-operative blood loss.