Controlled infusion of profilactic oxytocin dose during ceasarean section

Abstract

Background and Goal of Study: Postpartum haemorrhage (PPH) is the top cause of maternal mortality, accounting for nearly a quarter of parturient deaths worldwide. The main reason for PPH is uterine atony, therefore increasing the routine use of uterotonic agents for all women during delivery should help to reduce the PPH- determining morbidity and mortality. The administration of exogenous oxytocin is the most typical method because it is thought that additional oxytocin further stimulates uterine contractility. This study investigates if there is a difference between oxytocin injection routes during caesarean section. Our hypothesis is that oxytocin delivered via an automatic injection pump (AIS) is the more accurate way and even smaller doses can be more effective. Materials and Methods: The local ethics committee approved this prospective controlled trial. AKL infused with 500 ml of crystalloids (n=10) and others received 5 units of oxytocin through an automatic injection pump (AIS) per 10 minutes (n=10). Data were analyzed with SPSS. P level< 0.05 was considered significant. Results and Discussion: The total dose of oxytocin was 2.5 times lower in the AIS group (15 ± 5.7 IU and 6 ± 2.1 IU respectively, p<0.001). The need for additional oxytocin dose was higher in the infusion group (n = 8 respectively n = 2, p = 0.023,). The more significant amount of blood loss (1280 ± 181.353 and 460 ± 54.64 respectively, p<0.001) and need for intravenous fluid (2300 ± 258.19 and 2000 ± 0 respectively, p <0.023) were observed in the infusion group. There were no differences in heart rate or peripheral oxygen saturation between the groups, but changes in systolic and diastolic blood pressure are more affected by oxytocin infusion. It is easier to know the injected dose when AIS is used, and the even infusion of the uterotonic drug may be a key to more accurate uterine tonus control. Conclusion(s): The initial prophylactic dose of oxytocin is lower when it is delivered by an automatic syringe pump.