Oxytocin Administration During Cesarean Section

Study Overview
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Brief Summary
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Cesarean delivery is defined as fetal birth through incisions in the abdominal wall and the uterine wall. This definition does not include removal of the fetus from the abdominal cavity in the case of uterine rupture or in the case of an abdominal pregnancy The guidelines of the Royal College of Obstetricians and Gynaecologists on caesarean section recommend a slow intravenous bolus dose of 5 IU of oxytocin after delivery of the infant. Intravenous oxytocin has a short half life (4-10 minutes); therefore the potential advantage of an oxytocin infusion at caesarean section is in maintaining uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhage occurs

Official Title
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Oxytocin Administration During Cesarean Section Before Versus After Fetal Delivery Randomized Clinical Trial

Conditions
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Postpartum Hemorrhage

Intervention / Treatment
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* Drug: Oxytocin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primigravida or multigravida Term (37 - 42 weeks), Singleton pregnancies Booked for elective caesarean section. Accepting to participate in the study. Exclusion Criteria: • Medical disorders involving the heart, liver, kidney or brain. Diabetes mellitus and hypertension. Blood disorders (e.g. coagulopathies, thrombocytopenia) Patients requiring blood transfusion due to anemia. Risk factors for uterine atony e.g. macrosomia, polyhydramnios and multiple pregnancy. Previous 2 or more cesarean section Placenta previa or placental abruption Previous major obstetric haemorrhage (>1000 ml) in previous deliveries. Known fibroid or adenomyosis. Women who received anticoagulant therapy. Severe preeclampsis. Uterine anomalies.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: study group<br>100 women were assigned to receive an intravenous infusion of oxytocin 30 units in a rate 125 mL/hour minutes diluted into 500 mL of normal 0.9% sodium chloride) immediately after opening the visceral peritoneum just before incising the uterine wall during Cesarean section | Drug: Oxytocin<br>* intravenous infusion of oxytocin 30 units over 5 minutes diluted into 500 mL of normal 0.9% sodium chloride<br>|
| Active Comparator: Control group<br>100 women were assigned to an intravenous infusion of oxytocin 30 units in a rate 125 mL/hour diluted into 500 mL of normal 0.9% sodium chloride) immediately after clamping the umbilical cord during cesarean section | Drug: Oxytocin<br>* intravenous infusion of oxytocin 30 units over 5 minutes diluted into 500 mL of normal 0.9% sodium chloride<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| rate of blood loss | collection of the blood in the drape below the patient | 4 hours |