Effect of intrapartum use of oxytocin on estimated blood loss and hematocrit change at vaginal delivery. 1996

C C Goldberg, and M A Kallen, and C M McCurdy, and H S Miller
University of Arizona College of Medicine, Tucson, USA.

We hypothesized that exogenous oxytocin given for labor induction or augmentation results in a greater blood loss at vaginal delivery compared with spontaneous labor. Second, we theorized that duration of exposure, and maximum or final dosage of oxytocin, would be positively correlated with blood loss. We retrospectively studied records of 111 women undergoing labor induction or augmentation by oxytocin infusion along with those of 76 women who had spontaneous labor. The outcomes evaluated included clinically estimated blood loss (EBL), and a change of hematocrit from admission to postpartum. These were further compared to duration and dosage of oxytocin infused. A combination of chi-square and analysis of variance were used to compare the study group with the controls. Regression analysis was used to evaluate possible relationships within the study group. The demographics of the study group who received oxytocin were similar to those of the control group, with the exception of the percent who received an epidural (77% versus 29%, p < 0.0001) and length of labor (381 versus 277 min, p < 0.001). There was no demonstrated relationship between oxytocin use and EBL or hematocrit change. Within the study group of 111 patients, there was a statistically significant increase in EBL (p < 0.01) and hematocrit change (p < 0.0003) with increasing maximum dose of oxytocin. In addition, hematocrit change was greater with an increase in both duration (p < 0.001) and final dose of oxytocin (p < 0.0003). No relationship was demonstrated between exogenous oxytocin administration and increased blood loss, in a group of patients matched for variables other than spontaneous or oxytocin exposed labors. However, among those patients who received oxytocin, there was a correlation between amount of oxytocin exposure and blood loss. The initial hypothesis compared means between the two groups; however, the latter hypothesis sought to correlate increased exposure to oxytocin with increasing blood loss as measured by duration, maximum, and final dose.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007751 Labor, Induced Artificially induced UTERINE CONTRACTION. Induced Labor,Induction of Labor,Labor Induced,Labor Induction,Induced, Labor,Induction, Labor,Inductions, Labor,Labor Inductions
D010120 Oxytocics Drugs that stimulate contraction of the myometrium. They are used to induce LABOR, OBSTETRIC at term, to prevent or control postpartum or postabortion hemorrhage, and to assess fetal status in high risk pregnancies. They may also be used alone or with other drugs to induce abortions (ABORTIFACIENTS). Oxytocics used clinically include the neurohypophyseal hormone OXYTOCIN and certain prostaglandins and ergot alkaloids. (From AMA Drug Evaluations, 1994, p1157) Oxytocic,Oxytocic Agent,Oxytocic Drug,Uterine Stimulant,Uterine Stimulants,Oxytocic Agents,Oxytocic Drugs,Oxytocic Effect,Oxytocic Effects,Agent, Oxytocic,Agents, Oxytocic,Drug, Oxytocic,Drugs, Oxytocic,Effect, Oxytocic,Effects, Oxytocic,Stimulant, Uterine,Stimulants, Uterine
D010121 Oxytocin A nonapeptide hormone released from the neurohypophysis (PITUITARY GLAND, POSTERIOR). It differs from VASOPRESSIN by two amino acids at residues 3 and 8. Oxytocin acts on SMOOTH MUSCLE CELLS, such as causing UTERINE CONTRACTIONS and MILK EJECTION. Ocytocin,Pitocin,Syntocinon
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D001810 Blood Volume Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME. Blood Volumes,Volume, Blood,Volumes, Blood
D005260 Female Females
D006400 Hematocrit The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value. Erythrocyte Volume, Packed,Packed Red-Cell Volume,Erythrocyte Volumes, Packed,Hematocrits,Packed Erythrocyte Volume,Packed Erythrocyte Volumes,Packed Red Cell Volume,Packed Red-Cell Volumes,Red-Cell Volume, Packed,Red-Cell Volumes, Packed,Volume, Packed Erythrocyte,Volume, Packed Red-Cell,Volumes, Packed Erythrocyte,Volumes, Packed Red-Cell
D006473 Postpartum Hemorrhage Excess blood loss from uterine bleeding associated with OBSTETRIC LABOR or CHILDBIRTH. It is defined as blood loss greater than 500 ml or of the amount that adversely affects the maternal physiology, such as BLOOD PRESSURE and HEMATOCRIT. Postpartum hemorrhage is divided into two categories, immediate (within first 24 hours after birth) or delayed (after 24 hours postpartum). Hemorrhage, Postpartum,Delayed Postpartum Hemorrhage,Immediate Postpartum Hemorrhage,Hemorrhage, Delayed Postpartum,Hemorrhage, Immediate Postpartum,Postpartum Hemorrhage, Delayed,Postpartum Hemorrhage, Immediate

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