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

Abstract

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.