Department of Obstetrics and Gynecology in Norrköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Sweden.
Department of Obstetrics and Gynecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Sweden.
Sex Reprod Healthc. 2021 Sep;29:100641. doi: 10.1016/j.srhc.2021.100641. Epub 2021 Jun 11.
Oxytocin is the drug of choice in preventing postpartum hemorrhage (PPH). The aim was to compare the peroperative- and total blood loss within two hours and PPH after planned cesarean section (CS) when receiving 2.5 IU vs 5.0 IU of oxytocin in different risk groups for PPH.
A pilot study including 927 women undergoing planned CS where women receiving 2.5 IU of oxytocin were compared to women receiving 5.0 IU of oxytocin.
Data comparing peroperative blood loss, total blood loss within two hours and PPH were analyzed.
The women receiving 2.5 IU of oxytocin had a slightly higher peroperative blood loss, compared to the 5.0 IU group (476 ml vs 426 ml, p = 0.029). The total blood loss two hours after surgery showed no significant difference between the groups (626 ml vs 595 ml, p = 0.230). In the 2.5 IU group 13% had a blood loss ≥ 1000 ml vs 10% in the 5 IU group (aOR 1.64, 95% CI = 1.05-2.56). When the women considered to be at high risk for postpartum hemorrhage were excluded, we found no difference in the likelihood for postpartum hemorrhage between the groups (aOR 1.13, 95% CI = 0.64-1.99).
Women undergoing planned CS and receiving 2.5 IU of oxytocin had a slightly higher risk for postpartum hemorrhage in this study. However, a lower dose of 2.5 IU of oxytocin seems to be a safe option in planned CS for women without known risk factors for postpartum hemorrhage, but further research is needed to confirm these findings.
缩宫素是预防产后出血（PPH）的首选药物。本研究旨在比较不同 PPH 风险人群在计划剖宫产（CS）中接受 2.5IU 和 5.0IU 缩宫素时，术中及术后 2 小时内出血量和 PPH 的情况。
一项纳入 927 例行计划 CS 妇女的试点研究，比较了接受 2.5IU 缩宫素的妇女与接受 5.0IU 缩宫素的妇女。
分析比较术中出血量、术后 2 小时内总出血量和 PPH 的数据。
与 5.0IU 组相比，接受 2.5IU 缩宫素的妇女术中出血量略高（476ml 比 426ml，p=0.029）。两组术后 2 小时总出血量无显著差异（626ml 比 595ml，p=0.230）。在 2.5IU 组中，13%的患者出血量≥1000ml，而 5.0IU 组中为 10%（优势比 1.64，95%可信区间为 1.05-2.56）。当排除产后出血风险较高的妇女时，两组产后出血的可能性无差异（优势比 1.13，95%可信区间为 0.64-1.99）。
本研究中，接受 2.5IU 缩宫素的计划 CS 妇女发生产后出血的风险略高。然而，对于没有产后出血已知危险因素的妇女，接受 2.5IU 的低剂量缩宫素似乎是一种安全的选择，但需要进一步研究来证实这些发现。
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