Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens

Yamaguchi, Eduardo Tsuyoshi; Cardoso, Marcio Vivan; Torres, Marcelo Luís Abramides; Nascimento, Renato César Rijo Do; Ribeiro, Meireluci Costa; Frerichs, Elke; Payen, D

doi:10.1016/j.ijoa.2011.03.004

Cited by 24 publications

(15 citation statements)

References 14 publications

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“…Blood transfusion can be required in up to 20% of the women during abdominal myomectomy. Oxytocin is the agent of choice in the prevention of postpartum uterine atony and bleeding, [16][17][18] but should be used cautiously because an intravenous bolus of 10 IU oxytocin could be detrimental to women with heart disease or to women who are hypovolemic. However, these strategies may be associated with some complications, and some of these are ineffective or expensive or required extra steps before the actual procedure.…”

Section: Introductionmentioning

confidence: 99%

“…Its main function is uterine contraction during labour and delivery. Oxytocin is the agent of choice in the prevention of postpartum uterine atony and bleeding, [16][17][18] but should be used cautiously because an intravenous bolus of 10 IU oxytocin could be detrimental to women with heart disease or to women who are hypovolemic. 19 Oxytocin receptors exist in the non-pregnant uterus, although the concentration of the receptors is much lower than in its pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double‐blind randomised controlled trial

Atashkhoei

Fakhari

Pourfathi

et al. 2016

BJOG

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double‐blind randomised controlled trial

Atashkhoei

Fakhari

Pourfathi

et al. 2016

BJOG

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“…The total oxytocin dose and duration of administration also varied between studies, from 10 IU in 15 minutes [ 21 ] to 30 IU in 4 hours [ 19 ]. This can have important clinical implications since the dose of oxytocin infused influences oxytocin plasma levels in a dose dependent way [ 23 , 24 ]. This could lead to differences in the effects of the drug on uterine contraction, and consequent volume of blood loss, as well as adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

et al. 2021

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Background There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH). Objectives Assess the effects of administrating prophylactic oxytocin at different times during CS. Methods We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty. Results We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15–2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69–2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18–0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13–1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12–72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting. Conclusions In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

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“…Nevertheless, they are in agreement with previously studied concentrations and those used in clinical settings. 14,15,22 The plasma levels of oxytocin during pregnancy, labour, and postpartum have been reported to be variable and range from 10 -12 to 10 -8 M. [41][42][43][44] These may, however, not accurately reflect local myometrial concentration. The range of oxytocin (10 -10 to 10 -5 M) used during the dose-response testing likely reflects the levels reached after its parenteral administration postpartum.…”

Section: Discussionmentioning

confidence: 99%

The effect of morbid obesity or advanced maternal age on oxytocin-induced myometrial contractions: an in vitro study

Luca

Carvalho

Ramachandran

et al. 2020

Can J Anesth/J Can Anesth

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The purpose of this study was to investigate myometrial contractility induced by oxytocin in women with advanced maternal age (AMA) and morbid obesity (MO). We hypothesized that both oxytocinpretreated and oxytocin-naïve myometrial tissues from women of AMA and women who are MO would exhibit poor myometrial contractility compared with women that are younger and of normal body mass index (BMI). Methods This prospective in vitro study was conducted using myometrial samples obtained from women undergoing elective Cesarean deliveries. Three groups of patient were studied: control (B 35 yr; BMI, 20-24.9 kgÁm-2), AMA (C 40 yr; BMI, 20-24.9 kgÁm-2), and MO (B 35 yr BMI, C 40 kgÁm-2). Each myometrial strip was

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Serum oxytocin concentrations in elective caesarean delivery: a randomized comparison of three infusion regimens

Cited by 24 publications

References 14 publications

Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double‐blind randomised controlled trial

Effect of oxytocin infusion on reducing the blood loss during abdominal myomectomy: a double‐blind randomised controlled trial

Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

The effect of morbid obesity or advanced maternal age on oxytocin-induced myometrial contractions: an in vitro study

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