The risk of postpartum hemorrhage when lowering the oxytocin dose in planned cesarean section, a pilot study

Abstract

ObjectivesOxytocin 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. Study designA 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. Main outcome measuresData comparing peroperative blood loss, total blood loss within two hours and PPH were analyzed. ResultsThe 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). ConclusionsWomen 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.