Early Versus Late Administration of Intravenous Oxytocin Infusion in The Prevention of Blood Loss during Elective Cesarean Section - A Randomized-Controlled Trial

BACKGROUND: Oxytocin has been shown to be an effective uterotonic agent in the prevention of postpartum hemorrhage.
This study’s objective was to evaluate whether administering oxytocin infusion just before uterine incision (group 1) is more effective than administering oxytocin infusion after cord clamping (group 2) in preventing blood loss in elective cesarean sections in Ekiti State University Teaching Hospital, Ado-Ekiti.
METHODS: Women who were scheduled for elective cesarean section at term (> 37 weeks) and were eligible were randomized into group 1 or group 2. The outcome measures were intra- and postoperative blood loss and the need for additional uterotonics, blood transfusion or surgeries. Data were compared using chi-square and student t-tests.
RESULTS: A total of 250 women were randomized into the study. The mean intra-operative and total blood loss was significantly lower in group 1 compared to group 2 [(339.98 ± 84.9ml versus 363.69 ± 48.69ml, p = 0.007); (682.06 ± 74.64ml versus 711.26 ± 62.54ml, p = 0.001) respectively]. Significantly more women in group 2 required additional uterotonics than women in group 1; p = 0.023. The need for blood transfusion and additional surgery were similar in both groups; p > 0.05. There was no difference in Apgar scores at 1 or 5 minutes or in neonatal intensive care unit among the groups; p > 0.05. No maternal or perinatal deaths were recorded in both groups.
CONCLUSION: Early administration of oxytocin infusion is associated with a reduction in blood loss and the need for additional uterotonics or surgeries during elective Cesarian Section.

Keywords
Oxytocin Infusion; Blood Loss; Uterotonics; Postpartum Hemorrhage; Cesarean Section