Preoperative Oxytocin Infusion to Reduce Blood Loss During Emergency Cesarean Section: A Double-Blind Randomized Controlled Trial

Abstract

A bstract Background: Uterine atony, a known cesarean section (CS) complication, is the most common cause of postpartum hemorrhage. Objectives: To compare the effect of initiating intravenous oxytocin infusion before uterine incision versus after umbilical cord clamping on blood loss during elective CS. Materials and Methods: It was a double-blinded randomized clinical trial of participants who had elective CS at term. The intervention group received 40 IU of oxytocin in 1 L of normal saline and started just before the uterine incision, while the control group received the same dose of oxytocin infusion after umbilical cord clamping. Data were analyzed using SPSS version 24. The chi-square test was used to compare categorical variables, while the t -test was used to compare means between groups for quantitative variables. P value ≤ 0.05 was considered statistically significant. Results: The mean intraoperative blood loss was significantly less in the intervention than in the control group (432.37 ± 57.25 mL vs. 542.93 ± 73.04 mL; P < 0.001). The need for additional uterotonics was also significantly higher in the intervention group compared with the control group ( P = 0.002). Conclusion: Intravenous oxytocin infusion initiation before uterine incision during CS is associated with a reduction in intraoperative blood loss and the need for additional uterotonics. Trial Registration: The trial was registered at the Pan African Clinical Trial Registry with approval number PACTR20211183081329.