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Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome

PURPOSE: Postpartum haemorrhage (PPH) represents a leading cause of maternal morbidity and mortality. Giving oxytocin after birth reduces the risk for PPH. It has never been tested whether different methods of oxytocin administration affect the maternal outcome. This study aims to compare the infusi...

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Autores principales: Löytved-Hardegg, Julia J., Brunner, Mirjam, Ries, Jean-Jacques, von Felten, Stefanie, Heugel, Christina, Lapaire, Olav, Voekt, Cora, Hösli, Irene
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863908/
https://www.ncbi.nlm.nih.gov/pubmed/26538357
http://dx.doi.org/10.1007/s00404-015-3916-6
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author Löytved-Hardegg, Julia J.
Brunner, Mirjam
Ries, Jean-Jacques
von Felten, Stefanie
Heugel, Christina
Lapaire, Olav
Voekt, Cora
Hösli, Irene
author_facet Löytved-Hardegg, Julia J.
Brunner, Mirjam
Ries, Jean-Jacques
von Felten, Stefanie
Heugel, Christina
Lapaire, Olav
Voekt, Cora
Hösli, Irene
author_sort Löytved-Hardegg, Julia J.
collection PubMed
description PURPOSE: Postpartum haemorrhage (PPH) represents a leading cause of maternal morbidity and mortality. Giving oxytocin after birth reduces the risk for PPH. It has never been tested whether different methods of oxytocin administration affect the maternal outcome. This study aims to compare the infusion versus the bolus application of oxytocin after singleton vaginal delivery. METHODS: This retrospective monocentre study compares the incidence of clinically relevant postpartum complications in women receiving 5 IE of oxytocin as a bolus or as a 100 ml-infusion over 5 min, given immediately after birth. Included were women delivering singletons vaginally at term. We used propensity score weighting to compare outcomes between women receiving bolus and infusion and to minimize the selection bias in this retrospective cohort. RESULTS: 1765 patients were included. Patient characteristics were balanced. We found no significant differences for the combined overall postpartum adverse outcome (the incidence of PPH, manual removal of the placenta and/or curettage). For the single outcomes, we observed a significantly higher frequency of manual removal of the placenta (Odds ratio 1.47, 95 % CI 1.02–2.13) and a slightly higher but clinically not relevant estimated blood loss (Relative effect 1.05, 95 % CI 1.01–1.10) in the infusion group. CONCLUSION: The data show a tendency towards more complications in the infusion group. It is related to a more frequent need for manual removal of the placenta.
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spelling pubmed-48639082016-05-25 Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome Löytved-Hardegg, Julia J. Brunner, Mirjam Ries, Jean-Jacques von Felten, Stefanie Heugel, Christina Lapaire, Olav Voekt, Cora Hösli, Irene Arch Gynecol Obstet Maternal-Fetal Medicine PURPOSE: Postpartum haemorrhage (PPH) represents a leading cause of maternal morbidity and mortality. Giving oxytocin after birth reduces the risk for PPH. It has never been tested whether different methods of oxytocin administration affect the maternal outcome. This study aims to compare the infusion versus the bolus application of oxytocin after singleton vaginal delivery. METHODS: This retrospective monocentre study compares the incidence of clinically relevant postpartum complications in women receiving 5 IE of oxytocin as a bolus or as a 100 ml-infusion over 5 min, given immediately after birth. Included were women delivering singletons vaginally at term. We used propensity score weighting to compare outcomes between women receiving bolus and infusion and to minimize the selection bias in this retrospective cohort. RESULTS: 1765 patients were included. Patient characteristics were balanced. We found no significant differences for the combined overall postpartum adverse outcome (the incidence of PPH, manual removal of the placenta and/or curettage). For the single outcomes, we observed a significantly higher frequency of manual removal of the placenta (Odds ratio 1.47, 95 % CI 1.02–2.13) and a slightly higher but clinically not relevant estimated blood loss (Relative effect 1.05, 95 % CI 1.01–1.10) in the infusion group. CONCLUSION: The data show a tendency towards more complications in the infusion group. It is related to a more frequent need for manual removal of the placenta. Springer Berlin Heidelberg 2015-11-04 2016 /pmc/articles/PMC4863908/ /pubmed/26538357 http://dx.doi.org/10.1007/s00404-015-3916-6 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Maternal-Fetal Medicine
Löytved-Hardegg, Julia J.
Brunner, Mirjam
Ries, Jean-Jacques
von Felten, Stefanie
Heugel, Christina
Lapaire, Olav
Voekt, Cora
Hösli, Irene
Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title_full Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title_fullStr Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title_full_unstemmed Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title_short Replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
title_sort replacement of oxytocin bolus administration by infusion: influences on postpartum outcome
topic Maternal-Fetal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863908/
https://www.ncbi.nlm.nih.gov/pubmed/26538357
http://dx.doi.org/10.1007/s00404-015-3916-6
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