Abstract
Objective
To investigate a possible relationship between the oxytocin dose at caesarean section
and blood loss.
Study design
Retrospective analysis of computerised data for all caesarean sections in a UK maternity
unit delivering 6000 women annually during 1995–2009 and thus for seven years before
and after the 2001 recommended change in oxytocin dose. Validation of computerised
and hand-checked clinical data for 1996 and 2006 was performed and annual frequency
of blood loss >1000 ml was observed.
Results
Validation showed most variables recorded were similar for both acquisition methods.
For 17,405 (98.9%) caesarean sections with blood loss recorded, excess or severe loss
occurred in 127 (1.6%) of 7177 cases during 1995–2001 compared with 362 (4.0%) of
9035 during 2003–2009 (OR 2.317, CI 1.888–2.843). It was significantly more frequent
with multiple than singleton pregnancies (OR 1.946, CI 1.417–2.673), with general
than neuraxial anaesthesia (OR 4.296, CI 3.479–5.305) and with non-longitudinal than
longitudinal fetal lie (OR 1.942, CI 1.501–2.512). Excluding these three groups, excess
blood loss was still more frequent during 2003–2009 than 1995–2001 (OR 3.181, CI 2.374–4.263).
Oxytocin given during labour did not influence the frequency of excess blood loss.
Conclusions
The increased rate of excess blood loss at caesarean section during the latter period
could be the result of the reduced oxytocin dose. If similar observations are made
by others, this possible relationship should be investigated with appropriate objective
randomised studies.
Keywords
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Article info
Publication history
Published online: November 24, 2015
Accepted:
October 28,
2015
Received in revised form:
July 22,
2015
Received:
May 15,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
