Low-dose oxytocin - a safe strategy in postpartum hemorrhage

Thangaraju, Pugazhenthan; Varthya, Shoban Babu; Venkatesan, Sajıtha

doi:10.4103/ijp.ijp_62_19

Cited by 3 publications

(4 citation statements)

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“…Therefore, the detection of changes in D-Di level can be used as an auxiliary indicator for the diagnosis of PE, and also determine the severity of the disease and prognosis, providing a basis for twin pregnancy management and clinical diagnosis and treatment. 12,13 TT mainly reflects the time of fibrinogen conversion to fibrin, and the content and activity of FIB in the blood. In general, TT and FIB have opposite trends, which is more obvious in the late pregnancy of PE.…”

Section: Discussionmentioning

confidence: 99%

Blood Coagulation Indices in Twin Pregnancy Complicated with Preeclampsia

Liu

Zhang

Chen

et al. 2020

J Coll Physicians Surg Pak

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Section: Discussionmentioning

confidence: 99%

Blood Coagulation Indices in Twin Pregnancy Complicated with Preeclampsia

Liu

Zhang

Chen

et al. 2020

J Coll Physicians Surg Pak

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“…This study concluded that lower doses are preferred over higher doses; the incidence of uterine atony in the low-dose group was 0.7% and in the high-dose group was 5.1%. It indicates that higher doses cause uterine atony because of receptor desensitization, resulting in ineffective action on the uterine myometrium, and concludes that there is no difference in the regular dose (10 U) and high-dose groups as low doses are better tolerated and have similar efficacy [ 14 ]. WHO recommendations for the prevention and treatment of PPH stated that oxytocin (10 U, IV/IM) is the recommended uterotonic of choice.…”

Section: Discussionmentioning

confidence: 99%

“…PPH-preventing interventions such as negative suction devices assist the natural contractility and retractility of uterine musculature and aid in preventing atonicity of the uterus and blood loss when integrated with conventional AMTSL. Such additional measures are instrumental in decreasing blood loss in the third stage of labor and preventing postpartum hemorrhage [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

Application of a Negative Intrauterine Pressure Suction Device for Prophylactic Management of Atonic Postpartum Hemorrhage: A Quality Improvement Study

Sharma¹,

Kollabathula²,

Jindal³

et al. 2023

Cureus

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Background: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide. PPH-preventing interventions need to be prioritized and can be integrated with conventional methods of PPH prevention. The introduction of negative intrauterine pressure using a suction cannula can be one of the cheapest modalities to decrease PPH secondary to uterine atonicity. This method has brought a renaissance to practical obstetrics in low-middle income countries (LMIC), where the cost and availability of uterotonics are major health issues. Methods: It was a prospective quality improvement (QI) study conducted in the labor and delivery wards of a tertiary care medical institute and teaching center over the duration of one year. We aimed to assess the decrease in the incidence of atonic PPH with a negative intrauterine pressure suction device (NIPSD) integrated with active management of the third stage of labor (AMTSL) in the prevention of atonic PPH following normal vaginal delivery in low-risk antenatal women. In the initial six months, routine AMTSL was instituted for all consenting women (group 1). In the next six months, NIPSD was integrated with AMTSL (group 2). Data pertaining to the amount of blood loss, the incidence of primary PPH, uterine tone, fall in hemoglobin and hematocrit levels post-delivery, need for blood transfusion, and doctor and patient satisfaction were tabulated for all patients. Results: A total of 1324 consenting women were eligible for enrollment during the study time frame. In the initial six months (baseline period, group 1), 715 participants were subjected to routine AMTSL in the third stage of labor. During the intervention phase (group 2), 609 parturient women were recruited. There was no significant difference in baseline parameters between the two groups. With the introduction of NIPSD to routine AMTSL, there was a significant decrease in the average volume of blood loss during vaginal delivery (group 1 = 389.45+65.42 ml, group 2 = 216.66+34.27 ml; p-value = 0.012). The incidence of atonic PPH was reduced by more than 75% (group 1 = 13 women, group 2 = 3 women; p-value = 0.001) after the introduction of NIPSD complementing routine AMTSL. The introduction of NIPSD has also been instrumental in reducing the cost burden on patient and hospital expenditures. The net benefit of its introduction resulted in a reduction of the overall cost burden of blood transfusions by around 70%. Conclusion: PPH is a public health problem, and measures to reduce PPH must be implemented to decrease this health burden. In countries with low resources, complementing routine AMTSL with NIPSD can be instrumental in decreasing the incidence of PPH. Considering its cost-effectiveness and reusability, LMIC can adopt NIPSD as a routine measure in all vaginal deliveries.

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“…The use of anticoagulants plays an important role in the treatment of AF (Kalra et al, 2018). Warfarin, as a coumarin anticoagulant, can make the coagulation factor stay in the inactive precursor stage through inhibiting the liver vitamin K epoxide reductase (Thangaraju et al, 2019), so the purpose of anticoagulation therapy is achieved (Wang et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Association of the MYH6 Gene Polymorphism with the Risk of Atrial Fibrillation and Warfarin Anticoagulation Therapy

Fu¹,

Chen²,

Xu³

et al. 2021

Genetic Testing and Molecular Biomarkers

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Objective: To study the associations of single nucleotide polymorphisms (SNP) of the myosin heavy chain 6 (MYH6) gene with the risk of atrial fibrillation (AF) and warfarin anticoagulation therapy. Methods: Sanger sequencing was employed to analyze the genotypes of the MYH6 gene's rs28730771, rs365990, and rs2277473 loci in 243 AF patients and 243 non-AF patients (control group) selected according to the age and sex of AF patients at a 1:1 ratio. A multiple logistic regression analysis was used to analyze the risk factors in AF. SHEsis was adopted to analyze the association between rs28730771, rs365990, rs2277473 haplotypes and susceptibility to AF. The average weekly doses of warfarin administered to AF patients with different genotypes were compared. Results: The T allele at rs28730771 of the MYH6 gene (odds ratio [OR] = 2.82, 95% confidence interval [CI]: 1.73-4.59, p < 0.01), the G allele at rs365990 (OR = 1.65, 95% CI: 1.22-2.24, p < 0.01) and the T allele at rs2277473 (OR = 1.91, 95% CI: 1.25-2.91, p < 0.01) were significantly associated with an elevated risk of AF. The results of a logistic regression analysis demonstrated that hypertension, smoking, drinking, family history of stroke, as well as the genotypes at the rs28730771, rs365990, and rs2277473 loci were all risk factors in AF ( p < 0.05). The CAG haplotype for the three SNPs was associated with a reduced risk of AF susceptibility (OR = 0.61, 95% CI: 0.46-0.81, p < 0.01), and the CGG haplotype was related to an increased risk of AF (OR = 1.49, 95% CI: 1.07-2.06, p = 0.02). The doses of warfarin used in AF patients with different genotypes at the MYH6 rs28730771, rs365990, and rs2277473 loci were significantly different ( p < 0.05). Conclusion:The three SNPs (rs28730771, rs365990, and rs2277473) of the MYH6 gene loci were significantly associated with the risk of AF susceptibility and the dose of warfarin anticoagulant therapy.

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Low-dose oxytocin - a safe strategy in postpartum hemorrhage

Cited by 3 publications

References 5 publications

Blood Coagulation Indices in Twin Pregnancy Complicated with Preeclampsia

Blood Coagulation Indices in Twin Pregnancy Complicated with Preeclampsia

Application of a Negative Intrauterine Pressure Suction Device for Prophylactic Management of Atonic Postpartum Hemorrhage: A Quality Improvement Study

Association of the MYH6 Gene Polymorphism with the Risk of Atrial Fibrillation and Warfarin Anticoagulation Therapy

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