Postpartum Hemorrhage, Uterine Atony
Conditions
Keywords
Uterine atony, Postpartum hemorrhage, Vaginal delivery, Uterotonic, Oxytocin, Bolus, Evidence-based, Protocol
Brief summary
The purpose of this study will be to evaluate a standardized, evidence-based protocol versus a conventional approach for the dosing of oxytocin in vaginal delivery.
Detailed description
A traditional practice in many US hospitals includes use of 10-40 IU of Oxytocin mixed in various volumes of crystalloid administered at an unspecified and uncontrolled rate (quite often off the pump) in order to restore uterine tone and minimize routine blood loss in the third stage of labor. Many practitioners question high dose oxytocin regimens, timing and duration of Oxytocin administration for postpartum hemorrhage prophylaxis. Given the lack of a universally accepted, evidence based protocol, this study aims at comparing the efficacy of a traditional approach of administration of Oxytocin with an evidence-based designed algorithm.
Interventions
500 mL bag of oxytocin (30 IU / 500 mL) to be connected to the IV, and controlled at the obstetricians request. Up to two, 50 mL rapid infusion boluses to be given after delivery of anterior shoulder. Upon completing the bolus(es) flow rate should be continued at 100 mL / hour. This should total no more than 4.5 hours.
Sponsors
Study design
Eligibility
Inclusion criteria
* Vaginal Delivery
Exclusion criteria
* Cesarean Delivery * Allergy to Oxytocin * Cardiac Arrhythmia
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Estimated blood loss | 24 hours postpartum |