A Comparative Study between Oxytocin Intravenous Bolus versus Oxytocin Intravenous Bolus and Infusion for Control of Blood Loss at Elective Cesarean Section

Abstract

Background: One of the most crucial steps taken to stop postpartum hemorrhage (PPH) is to take a uterotonic medication as soon after delivery.
Objective: Our main objective was to determine which method was better for controlling intraoperative and early postoperative bleeding  after an elective Cesarean section (CS) whether intravenous (IV) oxytocin bolus or oxytocin bolus with infusion.
Patients and methods: Randomized controlled study that included 214 women who were scheduled for an elective Cesarean section  after 38 weeks were divided into two equal groups and given an IV slow bolus oxytocin 5 IU and a placebo infusion (500 ml of normal  saline over 4 hours) (Control group) or an IV slow bolus oxytocin 5 IU and an oxytocin infusion (40 IU in 500 ml of normal saline over 4 hours) (Study group). Following fetal delivery, all patients were administered the study medication.
Results: The need for additional uterotonics was statistically higher in group A than in group B 26 (24.3%) versus 14 (13.1%). While the  estimated blood loss was statistically insignificant between both groups (691.9 ± 233.6 ml in group A versus 543.1 ±179.4 ml in group B.
Conclusion: Following IV oxytocin slow bolus during an elective Cesarean section, an additional oxytocin infusion was not superior to IV  oxytocin slowbolus alone in reducing the operative blood loss but it may reduce the postoperative need for additional uterotonics