A Comparative Observational Study of Oxytocin Bolus and Oxytocin Infusion During Caesarean Section
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 11662-11673
Abstract
Background:To assess the statistically significant effects in the oxytocin bolus and infusion to decrease caesarean section postpartum haemorrhage.Postpartum haemorrhage (PPH) during Caesarean section is one of the most common causes of maternal death throughout the world > 72% in India. Although the value of routine oxytocics to reduce postpartum haemorrhage after vaginal birth has been well established, their value in caesarean section has received little attention. The present Prospective observational cross-sectional study is an attempt to compare the efficacy of intravenous oxytocin bolus dose followed by infusion and only intravenous oxytocin infusion following delivery of fetus in elective and emergency LSCS with regard to their influence on various parameters to prevention of postpartum haemorrhageMaterials and Methods: Present study was done at Department of Obestetrics & Gynecology,Dr. PSIMS &RF, Vijayawada, Andhra Pradesh, India and analysed the efficacy of intravenous oxytocin bolus followed by infusion and only intravenous oxytocin infusion on uterine tone, alterations in mean arterial pressure (MAP), alterations in heart rate (HR), blood loss by difference in hemoglobin and hematocrit, need for additional oxytocin and side effects of the drugs, if any in 350 low risk patients scheduled to undergo elective and emergency lower segment caesarean section under spinal anesthesia during the a period of September 2020 to April 2022.
Results: The average decline in hemoglobin was prevalent in group B with 4.51+/-0.1gm%. than in group A 3.69+/-1.28gm%. There was a homologous simultaneous decrease in PCV by16.42 +/- 3.1 in group B than in group A 13.25+/-1.46, which was statistically significant. There were fall in Hemoglobin and PCV in both the groups. There were improvements in uterine tone by 25th minute in both groups as compared to 5th minute. All patients in Group A and B had adequate to well contracted uterus.
Conclusion: It is concluded from this study that oxytocin intravenous bolus can be given in cases where atonic PPH is expected like, multifetal gestation, polyhydromnios, big baby, prolonged labour, obstructed labour.
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