The association between the time from oxytocin cessation during labour to Cesarean delivery and postpartum blood loss: a retrospective cohort study

Tran, Gary; Kanczuk, Marcelo Epsztein; Balki, Mrinalini

doi:10.1007/s12630-017-0874-4

Cited by 18 publications

(13 citation statements)

References 37 publications

(63 reference statements)

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“…Many authors have found positive associations between PPH and use of oxytocin during labor. 18,20,[25][26][27][28][29][30][31][32] However, in the existing PPH risk assessment tools, prolonged oxytocin exposure is mentioned as a risk factor for hemorrhage. 12 Women in the current study experienced an increased odds of PPH after mean (SD) of 4 (3.0) hours (Induction: Moderate Duration Admission).…”

Section: Discussionmentioning

confidence: 99%

“…This study adds to extant literature by quantifying a specific duration of oxytocin infusion that was associated with PPH outcomes during vaginal birth. Many authors have found positive associations between PPH and use of oxytocin during labor 18,20,25‐32 . However, in the existing PPH risk assessment tools, prolonged oxytocin exposure is mentioned as a risk factor for hemorrhage 12 .…”

Section: Discussionmentioning

confidence: 99%

“…404 (1.6) 124 115 1152 231 282 7Having both episiotomy and lacerations, n (%) 7925 (32.0) 3429 (31) 677 (22) 2225 (30) 1072 60522 (43) Instrument-assisted vaginal birth, n (%) 2096 (8.5) 679 (6) 113 4475 (6) 599 (34) 230 (19) Shoulder dystocia, n (%) 423 (1.7)…”

Section: Sample Description Of Maternal and Fetal Characteristics In mentioning

confidence: 99%

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Predicting Postpartum Hemorrhage After Vaginal Birth by Labor Phenotype

Erickson

Lee

Carlson

2020

J Midwife Womens Health

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Introduction: Postpartum hemorrhage (PPH) is an important contributor to maternal morbidity and mortality. Predicting which laboring women are likely to have a PPH is an active area of research and a component of quality improvement bundles. The purpose of this study was to identify phenotypes of labor processes (ie, labors that have similar features, such as duration and type of interventions) in a cohort of women who had vaginal births, estimate the likelihood of PPH by phenotype, and analyze how maternal and fetal characteristics relate to PPH risk by phenotype. Methods: This study utilized the Consortium for Safe Labor dataset (2002-2008) and examined term, singleton, vaginal births. Using 16 variables describing the labor and birth processes, a latent class analysis was performed to describe distinct labor process phenotypes. Results: Of 24,729 births, 1167 (4.72%) women experienced PPH. Five phenotypes best fit the data, reflecting labor interventions, duration, and complications. Women who had shorter duration of admission after spontaneous labor onset (admitted in latent or active labor) had the lowest rate of PPH (3.8%-3.9%). The 2 phenotypes of labor progress characterized by women who had complicated prolonged labors (spontaneous or induced) had the highest rate of PPH (8.0% and 12.0%, respectively). However, the majority of PPH (n = 881, 75%) occurred in the phenotypes with fewer complications. Prepregnancy body mass index did not predict PPH. Overall, the odds of PPH were highest among nulliparous women (odds ratio [OR], 1.52; 95% CI, 1.30-1.77), as well as Black women (OR, 1.39; 95% CI, 1.13-1.73) and Hispanic women (OR, 1.85; 95% CI, 1.56-2.20). Within phenotypes, maternal race and ethnicity, nulliparity, macrosomia, hypertension, and depression were associated with increased odds of PPH. Discussion: Women who were classified into a lower-risk labor phenotype and still experienced PPH were more likely to be nulliparous, a person of color, or diagnosed with hypertension.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Predicting Postpartum Hemorrhage After Vaginal Birth by Labor Phenotype

Erickson

Lee

Carlson

2020

J Midwife Womens Health

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“…37 Minimizing synthetic oxytocin use and considering decreasing or discontinuing use when active effective labor is established may help maximize oxytocin receptor availability such that women's uteri can respond to endogenous or exogenous postpartum oxytocin. [38][39][40] Strategies for prevention or quick repair of genital tract trauma should be a priority; 41 as it may be an overlooked driver of blood loss. 42 Finally, encouraging endogenous oxytocin release by assisting with early breastfeeding deserves further study.…”

Section: Discussionmentioning

confidence: 99%

“…Attention to maternal nutrition and hydration will help support effective uterine muscle contraction . Minimizing synthetic oxytocin use and considering decreasing or discontinuing use when active effective labor is established may help maximize oxytocin receptor availability such that women's uteri can respond to endogenous or exogenous postpartum oxytocin . Strategies for prevention or quick repair of genital tract trauma should be a priority; as it may be an overlooked driver of blood loss .…”

Section: Discussionmentioning

confidence: 99%

Physiologic childbirth and active management of the third stage of labor: A latent class model of risk for postpartum hemorrhage

Erickson

Lee

Grose

et al. 2018

Birth

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Association between duration of intrapartum oxytocin exposure and obstetric hemorrhage

Alexander

Wang²,

Srivastava³

et al. 2023

Arch Gynecol Obstet

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Purpose: Prolonged duration of intrapartum oxytocin exposure is included as a risk factor within widely adopted obstetric hemorrhage risk strati cation tools. However, the duration of exposure that confers increased risk is poorly understood. This study aimed to assess the association between duration of intrapartum oxytocin exposure and obstetric blood loss, as measured by quantitative blood loss, and hemorrhage-related maternal morbidity.Methods: This was a retrospective cohort study of all deliveries from 2018 to 2019 at a single medical center. We included patients who had received any intrapartum oxytocin, and we categorized them into 1 of 5 groups: >0-2, ≥2-4, ≥4-6, ≥6-12, and ≥12 hours of intrapartum oxytocin exposure. The primary outcomes were mean quantitative blood loss, proportion with obstetric hemorrhage (de ned as quantitative blood loss ≥ 1000 mL), and proportion with obstetric hemorrhage-related morbidity, a composite of hemorrhage-related morbidity outcomes. Secondary outcomes were hemorrhage-related pharmacologic and procedural interventions. A strati ed analysis was also conducted to examine primary and secondary outcomes by delivery mode.

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The association between the time from oxytocin cessation during labour to Cesarean delivery and postpartum blood loss: a retrospective cohort study

Cited by 18 publications

References 37 publications

Predicting Postpartum Hemorrhage After Vaginal Birth by Labor Phenotype

Predicting Postpartum Hemorrhage After Vaginal Birth by Labor Phenotype

Physiologic childbirth and active management of the third stage of labor: A latent class model of risk for postpartum hemorrhage

Association between duration of intrapartum oxytocin exposure and obstetric hemorrhage

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