Comparison of Different Dosages of Oxytocin Required After Elective Caesarean Delivery for Adequate Uterine Contraction

Kiran Ayesha; Yasmin Afridi; Farah Naz; Suresh Kumar; Imran Sikandar; Naheed Fatima

doi:10.29054/apmc/2022.1274

Kiran Ayesha Fellow, Department of Anesthesiology, Pakistan institute of Medical Sciences, SZABMU, Islamabad. Pakistan
Yasmin Afridi Associate Professor, Department of Anesthesiology, Pakistan Institute of Medical Sciences, SZABMU, Islamabad Pakistan
Farah Naz Assistant Professor, Department of Anesthesiology, Pakistan Institute of Medical Sciences, SZABMU, Islamabad Pakistan
Suresh Kumar Associate Professor, Department of Anesthesiology, Pakistan Institute of Medical Sciences, SZABMU, Islamabad Pakistan
Imran Sikandar Professor, Department of Anesthesiology, Pakistan institute of Medical Sciences, SZABMU, Islamabad Pakistan
Naheed Fatima Professor, Department of Anesthesiology, Pakistan institute of Medical Sciences, SZABMU, Islamabad Pakistan

DOI: https://doi.org/10.29054/apmc/2022.1274

Keywords: Uterotonic, Oxytocin, Uterine atony, Obstetric haemorrhage, Bolus, Hypotension, Elective caesarean

Abstract

Background: Following the delivery of the baby during a cesarean delivery, a uterotonic drug is administered as a standard procedure. The primary purpose of this is to prevent and treat uterine atony, which is the leading cause of obstetric hemorrhage. Oxytocin is typically the first-line uterotonic drug used for this purpose. Objective: Oxytocin was compared with 5 IU given IV 15 seconds after the delivery of baby and clamping of umbilical cord in women undergoing elective caesarean delivery, uterine tone was assessed at 3, 6 and 9 minutes and MAP was measured at 5 and 10 minutes. Study Design: A randomized control trial. Settings: Study was conducted at maternal and child health center (MCH) Department of Anesthesia PIMS Islamabad Pakistan. Duration: From June 2020 to November 2020. Methods: A total of 170 patients were included. Patients were randomly divided into two groups: Group A: Patients who received 3 IU oxytocin IV, Group B: Patients who received 5 IU oxytocin IV Adequate uterine tone and fall in mean arterial pressure was compared between both groups. Uterine tone was assessed by obstetrician at 3, 6 and 9 minutes and fall in MAP was recorded at 5 and 10 minutes after administration of bolus dose. All of the information was recorded via study proforma and SPSS version 20 was used for the data analysis. Results: A total of 170 patients were enrolled, their overall mean age was 29.55 ± 4.94 years. 96.5 % patients in group A had adequate uterine tone at 3 minutes compared with 98.8 % patients in group B (p = 0.312), 90.6 % patients in group A had adequate uterine tone at 6 minutes compared with 95.3 % patients in group B (p = 0.231) and 83.5 % patients in group A had adequate uterine tone at 9 minutes compared with 87.1 % patients in group B (p = 0.516). 9.4% of patients in group A had hypotension at 5 minutes compared with 31.8% patients in group B (p = 0.000) whereas 18.8% of patients in group A had hypotension at 10 minutes compared with 28.2% patients in group B (p =0.148). Conclusion: Adequate uterine contraction can be achieved with 3 IU of oxytocin. 3 IU of oxytocin observed to be an appropriate dose to use during elective caesarean deliveries to achieve adequate uterine tone without causing significant hypotension.