Atony, Uterine, Blood Loss, Postoperative, Blood Loss, Surgical, Cesarean Section Complications, Postoperative Pain, Postpartum Hemorrhage
Conditions
Keywords
Oxytocin, cesarean section, uterine atony, Postpartum Hemorrhage
Brief summary
This study compares the effect of starting intravenous oxytocin infusion early before uterine incision versus late after umbilical cord clamping on the blood loss during elective cesarean section
Detailed description
Postpartum hemorrhage (PPH) is still the major cause of maternal morbidity and mortality worldwide contributing to nearly 25% of direct maternal deaths. The average blood loss during cesarean section is 1000 ml which is nearly double the blood loss during vaginal delivery. Worldwide, the most commonly used uterotonic for the prevention of PPH is oxytocin. Several regimens of oxytocin have been tested during cesarean section with variable wanted (uterotonic) and unwanted (cardiovascular) effects. In the current study, we tested the hypothesis that initiating IV oxytocin infusion earlier before uterine incision would induce a rapid acceptable uterine contraction and minimize the intraoperative blood loss than the same dose administered after delivery of the fetus.
Interventions
OTHERbefore uterine incision oxytocin
blood loss during elective cesarean section
OTHERafter clamping the umbilical cord oxytocin
blood loss during elective cesarean section
Sponsors
Bezmialem Vakif University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 40 Years
Healthy volunteers
Yes
Inclusion criteria
* single fetus at term \>37 weeks of gestational age
Exclusion criteria
* history of previous cesarean section * history of previous uterine surgery * multiple gestation, placenta previa, polyhydramnious, fetal macrosomia * women at high risk for uterine atony such as anemia (Hb \< 8 gm/dL) * uterine atony history * gestational diabetes mellitus, gestational hypertension, preeclampsia, current or previous history of heart disease, liver, renal disorders or known coagulopath
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| blood loss during elective cesarean section | 2 hours | The intraoperative blood loss will be measured by adding the volume of the suction bottle with the blood soaked sponges (know dry weight). The blood loss was estimated after excluded amniotic fluid volume in the suction bottle in each case |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| postoperative blood loss | 24 hours | The hemoglobin and hematocrit values will be measured 24 hours after CS |
Other
| Measure | Time frame | Description |
|---|---|---|
| postoperative pain score | 24 hours | The Visual Analogue Scale (VAS) will be implemented postoperative day 0 and postoperative 1st day |
| neonatal wellbeing | 2 hours | Apgar scores (1 and 5 minutes) will be compared |
Countries
Turkey (Türkiye)
Outcome results
None listed