Maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of labour

摘要

Objectives: The safety of bolus oxytocin has been questioned due to reports of maternal hemodynamic consequences. This study compared maternal haemodynamic effects of oxytocin bolus or infusion in the third stage of vaginal delivery. Methodology: This was a randomized double-blind clinical trial in 170 women who received (10IU) intravenous oxytocin bolus or infusion in third stage of labour. Mean arterial pressure (MAP) and heart rate (HR) were measured before delivery and 1, 5, 10, 20 minutes after administration of oxytocin. These serial measurements and postpartum outcome were compared in two groups. Results were analyzed using analysis of variance for repeated measures, t-test, Man U Whitney, Fisher exact test, and chi-square test. Results: Findings showed MAP and HR did not vary between two groups (p= 0.38 and p= 0.65 respectively. Length of the third stage of labour, retained placenta and reduction in haemoglobin concentration for the bolus group was less than infusion group (p=0.000, p=0.042 and P=0.036 respectively). Other postpartum outcome was similar in two groups. Conclusion: Bolus oxytocin is not associated with adverse maternal hemodynamics and appeared to be as effective and can safely be administered in the third stage of labour.