Department of Obstetrics and Gynecology, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Pharmacol. 2018 Sep-Oct;50(5):279-283. doi: 10.4103/ijp.IJP_419_18.
Currently, recommended high-dose oxytocin regimen for the prevention of postpartum hemorrhage (PPH) following cesarean delivery (CD) is associated with maternal side effects frequency of which is greater with a higher cumulative dose and rapid administration of oxytocin. Here, we evaluated the efficacy of single-dose intravenous oxytocin over 2-4 h (total = 10 units) with oxytocin maintenance infusion for 8-12 h (total = 30 units) in postoperative CD women for the prevention of PPH.
The current double-blinded randomized controlled trial was carried out in a tertiary care institute in Southern India. The primary outcome measures included the following: (a) the need for additional uterotonics to control PPH and (b) significant deterioration of vital signs as assessed by pulse rate and blood pressure in the postoperative period. The secondary outcome measures were as follows: (a) significant difference (≥10% between preoperative and postoperative packed cell volume) and (b) need for blood transfusion.
Two hundred and seventy-one women were randomized into Group A (oxytoci = 10 units; = 135) and Group B (oxytoci = 30 units; = 136). Both the groups were comparable with regard to demographic characteristics. There was no difference in any of primary or secondary outcome measures in the two groups. Thus, low-dose oxytocin regimen is as effective as high-dose oxytocin regimen in the prevention of PPH in postoperative CD women.
目前，剖宫产术后预防产后出血（PPH）推荐的高剂量催产素方案与母体副作用有关，催产素剂量越高、给药速度越快，副作用发生频率越高。在此，我们评估了在剖宫产术后女性中，单次静脉注射催产素持续 2-4 小时（总量=10 单位）联合 8-12 小时催产素维持输注（总量=30 单位）用于预防 PPH 的疗效。
本研究为在印度南部一家三级保健机构进行的双盲随机对照试验。主要结局指标包括：（a）需要额外的宫缩剂来控制 PPH；（b）术后脉搏率和血压等生命体征的显著恶化。次要结局指标包括：（a）术后红细胞比容有显著差异（与术前相比≥10%）；（b）需要输血。
271 名女性被随机分为 A 组（催产素=10 单位；n=135）和 B 组（催产素=30 单位；n=136）。两组在人口统计学特征方面无差异。两组的主要或次要结局指标均无差异。因此，低剂量催产素方案与高剂量催产素方案在预防剖宫产术后 PPH 方面同样有效。
