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Intravenous oxytocin dosing regimens for postpartum hemorrhage prevention at cesarean section: A systematic review and meta-analysis

American Journal of Obstetrics and Gynecology May 06, 2021

Phung LC, Farrington EK, Connolly M, et al. - Researchers conducted this systematic review and meta-analysis to synthesize available evidence on intravenous (IV) oxytocin dosing regimens for the prevention of postpartum hemorrhage (PPH) at cesarean section (CS). The data were analyzed based on the type of IV administration (bolus only, infusion only, bolus plus infusion) and the oxytocin dose. The inclusion criteria were met by 35 studies (7,333 women), including 30 randomized trials and five non-randomized studies. There is a scarcity of data comparing IV oxytocin regimens for PPH prevention at CS. Bolus plus infusion regimens may result in minor decreases in mean blood loss, and initial bolus doses of < 5 IU may lessen nausea. Bolus only regimens of 10 IU vs 5 IU may reduce the need for additional uterotonics, but more comparative trials are needed to understand the effects on other key outcomes, especially hypotension.

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