Weight‐based versus fixed dose oxytocin infusion for preventing uterine atony during cesarean section in laboring patients: A randomized trial

Abstract

AbstractObjectiveWe compared efficacy of weight‐based (0.4 IU/kg/h) versus fixed‐dose (34 IU/h) oxytocin infusion during cesarean section.MethodsThe oxytocin infusion in either group (n = 32 each) was initiated upon cord clamping. Primary outcome measure was adequacy of uterine tone at 4 min after initiating oxytocin infusion. Oxytocin associated side effects were also observed.ResultsSignificantly less oxytocin was used with the weight‐based versus fixed‐dose regimen (16.3 [11.2–22.4] IU vs 20.4 [15.8–26.9] IU; P = 0.036). Incidence of adequate uterine tone was clinically greater but not significantly different with the weight‐based versus fixed‐dose regimen (81.3% vs 71.9%; P = 0.376). The weight‐based regimen was associated with clinically lesser, although not statistically significant need for rescue oxytocin (25% vs 46.9%; P = 0.068) and additional uterotonic (9.4% vs 15.6%; P = 0.708); as well as oxytocin associated side effects (hypotension [34.4% vs 46.9%; P = 0.309], nausea/vomiting [18.8% vs 40.6%; P = 0.055], and ST‐T changes [0% vs 3.1%; P = 1.000]).ConclusionWeight‐based oxytocin was not significantly different from the fixed‐dose regimen in terms of uterotonic efficacy or associated side‐effects, despite significantly lower doses being used. Use of weight‐based oxytocin infusion (0.4 IU/kg/h) can be considered in clinical practice.Trial RegistrationClinical Trial Registry of India (ctri.nic.in, number. CTRI/2021/01/030642).