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

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.