Oxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial.

Hdl Handle:
http://hdl.handle.net/10147/218013
Title:
Oxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial.
Authors:
Sheehan, Sharon R; Montgomery, Alan A; Carey, Michael; McAuliffe, Fionnuala M; Eogan, Maeve; Gleeson, Ronan; Geary, Michael; Murphy, Deirdre J
Affiliation:
Academic Department of Obstetrics and Gynaecology, Trinity College Dublin, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
Citation:
Oxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial. 2011, 343:d4661 BMJ
Journal:
BMJ (Clinical research ed.)
Issue Date:
2011
URI:
http://hdl.handle.net/10147/218013
PubMed ID:
21807773
Abstract:
To determine the effects of adding an oxytocin infusion to bolus oxytocin on blood loss at elective caesarean section.; Double blind, placebo controlled, randomised trial, conducted from February 2008 to June 2010.; Five maternity hospitals in the Republic of Ireland.; 2069 women booked for elective caesarean section at term with a singleton pregnancy. We excluded women with placenta praevia, thrombocytopenia, coagulopathies, previous major obstetric haemorrhage (>1000 mL), or known fibroids; women receiving anticoagulant treatment; those who did not understand English; and those who were younger than 18 years.; Intervention group: intravenous slow 5 IU oxytocin bolus over 1 minute and additional 40 IU oxytocin infusion in 500 mL of 0.9% saline solution over 4 hours (bolus and infusion). Placebo group: 5 IU oxytocin bolus over 1 minute and 500 mL of 0.9% saline solution over 4 hours (placebo infusion) (bolus only). Main outcomes Major obstetric haemorrhage (blood loss >1000 mL) and need for an additional uterotonic agent.; We found no difference in the occurrence of major obstetric haemorrhage between the groups (bolus and infusion 15.7% (158/1007) v bolus only 16.0% (159/994), adjusted odds ratio 0.98, 95% confidence intervals 0.77 to 1.25, P=0.86). The need for an additional uterotonic agent in the bolus and infusion group was lower than that in the bolus only group (12.2% (126/1033) v 18.4% (189/1025), 0.61, 0.48 to 0.78, P<0.001). Women were less likely to have a major obstetric haemorrhage in the bolus and infusion group than in the bolus only group if the obstetrician was junior rather than senior (0.57, 0.35 to 0.92, P=0.02).; The addition of an oxytocin infusion after caesarean delivery reduces the need for additional uterotonic agents but does not affect the overall occurrence of major obstetric haemorrhage. Trial Registration Current Controlled Trials ISRCTN17813715.
Language:
en
MeSH:
Adult; Blood Loss, Surgical; Cesarean Section; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Oxytocics; Oxytocin; Postpartum Hemorrhage; Pregnancy; Surgical Procedures, Elective; Treatment Outcome
ISSN:
1756-1833
Ethical Approval:
N/A

Full metadata record

DC FieldValue Language
dc.contributor.authorSheehan, Sharon R-
dc.contributor.authorMontgomery, Alan A-
dc.contributor.authorCarey, Michael-
dc.contributor.authorMcAuliffe, Fionnuala M-
dc.contributor.authorEogan, Maeve-
dc.contributor.authorGleeson, Ronan-
dc.contributor.authorGeary, Michael-
dc.contributor.authorMurphy, Deirdre J-
dc.date.accessioned2012-04-10T11:47:07Z-
dc.date.available2012-04-10T11:47:07Z-
dc.date.issued2011-
dc.identifier.citationOxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial. 2011, 343:d4661 BMJ-
dc.identifier.issn1756-1833-
dc.identifier.pmid21807773-
dc.identifier.urihttp://hdl.handle.net/10147/218013-
dc.description.abstractTo determine the effects of adding an oxytocin infusion to bolus oxytocin on blood loss at elective caesarean section.-
dc.description.abstractDouble blind, placebo controlled, randomised trial, conducted from February 2008 to June 2010.-
dc.description.abstractFive maternity hospitals in the Republic of Ireland.-
dc.description.abstract2069 women booked for elective caesarean section at term with a singleton pregnancy. We excluded women with placenta praevia, thrombocytopenia, coagulopathies, previous major obstetric haemorrhage (>1000 mL), or known fibroids; women receiving anticoagulant treatment; those who did not understand English; and those who were younger than 18 years.-
dc.description.abstractIntervention group: intravenous slow 5 IU oxytocin bolus over 1 minute and additional 40 IU oxytocin infusion in 500 mL of 0.9% saline solution over 4 hours (bolus and infusion). Placebo group: 5 IU oxytocin bolus over 1 minute and 500 mL of 0.9% saline solution over 4 hours (placebo infusion) (bolus only). Main outcomes Major obstetric haemorrhage (blood loss >1000 mL) and need for an additional uterotonic agent.-
dc.description.abstractWe found no difference in the occurrence of major obstetric haemorrhage between the groups (bolus and infusion 15.7% (158/1007) v bolus only 16.0% (159/994), adjusted odds ratio 0.98, 95% confidence intervals 0.77 to 1.25, P=0.86). The need for an additional uterotonic agent in the bolus and infusion group was lower than that in the bolus only group (12.2% (126/1033) v 18.4% (189/1025), 0.61, 0.48 to 0.78, P<0.001). Women were less likely to have a major obstetric haemorrhage in the bolus and infusion group than in the bolus only group if the obstetrician was junior rather than senior (0.57, 0.35 to 0.92, P=0.02).-
dc.description.abstractThe addition of an oxytocin infusion after caesarean delivery reduces the need for additional uterotonic agents but does not affect the overall occurrence of major obstetric haemorrhage. Trial Registration Current Controlled Trials ISRCTN17813715.-
dc.language.isoen-
dc.rightsArchived with thanks to BMJ (Clinical research ed.)en_GB
dc.subject.meshAdult-
dc.subject.meshBlood Loss, Surgical-
dc.subject.meshCesarean Section-
dc.subject.meshDouble-Blind Method-
dc.subject.meshDrug Therapy, Combination-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshInfusions, Intravenous-
dc.subject.meshOxytocics-
dc.subject.meshOxytocin-
dc.subject.meshPostpartum Hemorrhage-
dc.subject.meshPregnancy-
dc.subject.meshSurgical Procedures, Elective-
dc.subject.meshTreatment Outcome-
dc.titleOxytocin bolus versus oxytocin bolus and infusion for control of blood loss at elective caesarean section: double blind, placebo controlled, randomised trial.en_GB
dc.contributor.departmentAcademic Department of Obstetrics and Gynaecology, Trinity College Dublin, Coombe Women and Infants University Hospital, Dublin 8, Ireland.-
dc.identifier.journalBMJ (Clinical research ed.)-
dc.type.qualificationlevelN/Aen
cr.approval.ethicalN/Aen
dc.description.provinceLeinsteren
dc.description.provinceLeinster-
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