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  • Title: Use of additional oxytocin to reduce blood loss at elective caesarean section: A randomised control trial.
    Author: Güngördük K, Asicioglu O, Celikkol O, Olgac Y, Ark C.
    Journal: Aust N Z J Obstet Gynaecol; 2010 Feb; 50(1):36-9. PubMed ID: 20218995.
    Abstract:
    OBJECTIVE: The purpose of this prospective, randomised, double-blind, placebo-controlled study was to assess the effects of a 5-IU oxytocin bolus and placebo infusion versus a 5-IU oxytocin bolus and 30 IU infusion on the control of blood loss at elective lower segment caesarean section (C/S). METHODS: Participants with indication for elective C/S were randomly allocated to two groups. Group A, 360 women, received oxytocin 5 IU bolus and placebo; group B, 360 women received oxytocin 5 IU bolus and 30 IU infusion. Blood loss was estimated based on the haematocrit values before and 48 h after delivery. The primary outcome was the incidence of excessive bleeding (estimated blood loss of >1000 mL), while secondary outcomes included use of additional uterotonics, estimated blood loss, need for blood transfusion, duration of hospital stay and the incidence of adverse effects. RESULTS: No demographic difference was observed between groups. Mean estimated blood loss (P < 0.001) and the proportion of women with blood loss estimated to be greater than 1000 mL were significantly less for group B than for group A (relative risk (RR) 0.35, 95% confidence interval (CI) 0.20-0.63). In addition, more women in the group A required additional uterotonic agents (RR 0.35, 95% CI 0.22-0.56) and blood transfusion (RR 0.12, 95% CI 0.01-0.98). CONCLUSION: An additional oxytocin infusion after 5 IU oxytocin bolus infusion at elective C/S may reduce blood loss and required blood transfusion.
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