Effects of 5 IU oxytocin bolus and 20 IU oxytocin infusion compared to 5 IU oxytocin bolus and normal saline infusion in the control of blood loss during and after ante-partum lower segment caesarean section: a randomized controlled trial

Kajendran, J; Silva, G R C; Ranaraja, Sisira K

doi:10.4038/cmj.v62i3.8515

Cited by 6 publications

(6 citation statements)

References 19 publications

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“…There were no statistically significant differences between groups (P=0.67). In agreement with our study, the study of Kajendran et al (14) reported that there was no significant difference in mean length of stay in theatre and recovery in the intervention group (116.6 ± 56.0 minutes) and the control group 112.6 ± 46.8 minutes (p= 0.08).…”

Section: Discussionsupporting

confidence: 93%

Comparison between Oxytocin Bolus Versus Bolus Plus Infusion in Prevention of Postpartum Hemorrhage During Elective Cesarean Section

Ahmed¹,

Abdelsalam²,

El-fayomy³

et al. 2022

The Egyptian Journal of Hospital Medicine

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Background: The risk of postpartum hemorrhage, anemia, blood transfusions, hysterectomy, and even maternal mortality increases with a caesarean section. Hemorrhage control during and after Caesarean operation helps to reduce maternal mortality and morbidity. In most situations, uterine atony is linked to fatal obstetric hemorrhage. After a vaginal birth, oxytocin is commonly administered to reduce postpartum bleeding. Its usefulness in caesarean sections is still debatable.Objectives: This study aimed to evaluate the effectiveness of ten IU Intravenous oxytocin bolus in comparison with ten IU oxytocin bolus plus thirty IU oxytocin infusion on postpartum hemorrhage during elective cesarean section. Material and Method: At Maternity Hospital in Zagazig University Hospital. This study included 180 singleton pregnant women admitted for elective cesarean section in two groups. Patients in group A: received ten IU oxytocin intravenous bolus over one min and infusion of thirty IU oxytocin in 500 ml of 0.9 saline over four hours. While patients in group B: received ten IU oxytocin intravenous bolus over 1min and 500 ml of 0.9 saline over four hours. Results: We found that there was an insignificant difference in both groups according to the amount of blood loss. In Group (A) 10 (11.1%) patients needed blood transfusion while in Group (B) 11 (12.2%) patients needed blood transfusion, and this difference was insignificant P=0.6. Conclusion: After a caesarean delivery, an oxytocin infusion lowers the requirement for additional uterotonic drugs but has little effect on the overall incidence of significant obstetric haemorrhage.

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Section: Discussionsupporting

confidence: 93%

Comparison between Oxytocin Bolus Versus Bolus Plus Infusion in Prevention of Postpartum Hemorrhage During Elective Cesarean Section

Ahmed¹,

Abdelsalam²,

El-fayomy³

et al. 2022

The Egyptian Journal of Hospital Medicine

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“…Duffield compared low and high doses of oxytocin given as a continuous infusion. That study confirmed the previously mentioned result that both low (10 IU) and high (60 IU) infusion of oxytocin works in the same preventive regime [18].…”

Section: Discussionsupporting

confidence: 91%

“…The blood loss in the group of 20 IU oxytocin infusion was significantly less ( p = 0.046). Visual estimation of blood loss made by the surgeon ( p = 0.01) and anesthetist ( p = 0.03) was also significantly higher in the placebo group [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

“…Both Cecilia, Ghulmiyyah, and partly King, investigated the effect of oxytocin infusion without bolus dose. All of them found that the bolus of oxytocin is not necessary to achieve adequate and wanted uterine contraction and prevent PPH and the smaller dose of oxytocin (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) given as continuous infusion has the same effect as the bigger one [13,16,17]. This should also be taken into the consideration, as previously discussed, cardiovascular changes are observed almost in every patient given at least 5 IU bolus of oxytocin, so the strategy of using only the infusion of oxytocin could be further researched or bolus dose should be as small as possible.…”

Section: Discussionmentioning

confidence: 99%

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Prophylactic Dose of Oxytocin for Uterine Atony during Caesarean Delivery: A Systematic Review

Baliulienė

Vitartaitė

Rimaitis

2021

IJERPH

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Objective—to overview, compare and generalize results of randomized clinical trials analyzing different oxytocin doses to prevent postpartum hemorrhage, initiate and maintain uterine contraction after Caesarean delivery. Methods—‘PubMed’, ‘EMBASE’, ‘CENTRAL’, and ‘CINAHL’ electronic databases were searched for clinical trials analyzing the effectiveness of different dose of oxytocin given intravenously during surgery for uterine contraction and to reduce postpartum hemorrhage. A systematic review of relevant literature sources was performed. Results—our search revealed 813 literature sources. A total of 15 randomized clinical trials, comparing different doses of oxytocin bolus and infusion used after caesarean delivery have met the selection criteria. Conclusion—oxytocin bolus 0.5–3 UI is considered an effective prophylactic dose. Recommended effective prophylactic oxytocin infusion dose is 7.72 IU/h, but it is unanswered whether we really need a prophylactic infusion of oxytocin if we choose effective bolus dose size and rate. Adverse hemodynamic effects were observed when a 5 UI oxytocin bolus was used. However, topics such as bolus dose size, infusion dose size and requirement as well as bolus injection rate, still remain unanswered. The doses that are recommended in the guidelines of peripartum hemorrhage prophylaxis are not confirmed by randomized controlled double-blind trials and more research should cover this topic.

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“…During the review of the medical records, we found that the trigger "intravenous injection of calcium gluconate" was triggered 15 times (principally in patients with eclampsia or pre-eclampsia), but that no ADE was noted. Studies have shown that Ca + 2 stimulated neuromuscular excitement and promoted blood coagulation, and the intravenous injection of calcium gluconate before cesarean section reduced the amount of oxytocin, intraoperative and postoperative bleeding, and effectively prevented postpartum hemorrhage [53,54]. The condition of this trigger entry should therefore be de ned as "intravenous injection of calcium gluconate and Mg > 5 mmol•L − 1 .…”

Section: Revision Of Triggers Re Ecting a Low Ppvmentioning

confidence: 99%

Establishing a Trigger Tool Based on Global Trigger Tools to Identify Adverse Drug Events in Obstetric Inpatients in China

Wu¹,

Yin

et al. 2023

Preprint

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Background To examine the performance of an obstetric trigger tool, compared with the spontaneous reporting system (SRS) and global trigger tools (GTTs), in detecting adverse drug events (ADEs) experienced by obstetric units, and to assess the utility and value of the obstetric trigger tool in identifying ADEs of obstetric inpatients. Methods Our obstetric triggers were established on the basis of a literature review, retrospective obstetric ADE investigations, trigger extraction and revision, and expert investigations. We conducted a retrospective study to identity ADEs in 300 obstetric inpatient records at the Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital from June 1 to September 30, 2018. Results Through two rounds of expert investigation, we established 39 preliminary triggers that comprised four modules (12 laboratory tests, nine medications, 14 symptoms, and four outcomes). Three hundred medical records were reviewed by using the obstetric triggers with 49 cases of ADE detected, and the incidence of ADE was 16.33%. Among the 39 obstetric triggers, 22 triggers were positive (56.41%) and 11 of them detected ADE. The positive predictive value (PPV) was 36.36%, and the number of ADEs/100 patients was 16.33 (95% CI, 4.19–17.81). The ADE detection rate, positive trigger rate, and PPV value for the obstetric triggers were significantly augmented, confirming that the obstetric triggers were more specific and sensitive than SRS and GTT. Conclusion The obstetric triggers were proven to be sensitive and specific in the active monitoring of ADE for obstetric inpatients, and this could constitute a reference for ADE detection of obstetric inpatients at medical institutions.

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Effects of 5 IU oxytocin bolus and 20 IU oxytocin infusion compared to 5 IU oxytocin bolus and normal saline infusion in the control of blood loss during and after ante-partum lower segment caesarean section: a randomized controlled trial

Cited by 6 publications

References 19 publications

Comparison between Oxytocin Bolus Versus Bolus Plus Infusion in Prevention of Postpartum Hemorrhage During Elective Cesarean Section

Comparison between Oxytocin Bolus Versus Bolus Plus Infusion in Prevention of Postpartum Hemorrhage During Elective Cesarean Section

Prophylactic Dose of Oxytocin for Uterine Atony during Caesarean Delivery: A Systematic Review

Establishing a Trigger Tool Based on Global Trigger Tools to Identify Adverse Drug Events in Obstetric Inpatients in China

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