Comparison The Effect Of Different Oxytocin Administration Protocols On Blood Loss And Hemodynamics In Cesarean Section

Objective: To explore the best usage of oxytocin in cesarean section,to control the blood loss effectively while reducing the impact on hemodynamics.Methods: Ninety-seven parturients under elective cesarean section were chose in the First Affiliated Hospital of Suzhou University from March 2006 to March 2017.Among them,group A(38 cases)was treated with intrauterine injection of oxytocin 20 U after delivery,combined with oxytocin 20 U intravenous infusion(speed 0.3U / min).Group B(29 cases)was received intrauterine injection of oxytocin 20 U after delivery.Group C(30 cases)was received intrauterine injection of oxytocin 10 U after delivery.Three groups were treated with oxytocin 20 U intravenous infusion in 2 hours slowly after the operation.Parameters of hemodynamics(incidence of hypotension and tachycardia,changes of systolic blood pressure,diastolic blood pressure and heart rate),blood loss(intraoperative,2 hours and 24 hours postoperative),use of extra uterotonics,hemoglobin difference before and after operation and adverse events(nausea,vomiting,chest congestion,headache,etc)were observed and compared.Use SPSS 19.0 statistical software to analysis the data.Results: There were no statistically significant differences in the general condition of the three groups(maternal age,BMI,gestational age,gravidity,parity,neonatal sex,neonatal weight and Apgar score).The incidence of intraoperative hypotension was statistically different(P=0.035),and group A was significantly higher(P=0.011).The incidence of tachycardia was not significantly different.Excluding the impact of the intervention of anesthesia,there were statistically significant differences in the value of heart rate increased(1min:P=0.037,6min:P=0.025,12min:P=0.045).Group A was significantly higher(6min:P=0.021,12min:P=0.039).No significant differences in systolic blood pressure and diastolic blood pressure were appeared between the three groups.The intraoperative blood loss in group C was increased(P=0.039),but there were no significant differences in postoperative blood loss(2 and 24 hours),total blood loss,Hb difference,adverse reaction,incidence of postpartum hemorrhage,extra uterotonics,postoperative hemodynamic changes.Conclusion: Compared with the regime of intrauterine injection of oxytocin 20 U combined with 20 U intravenous infusion in cesarean section,simple intrauterine injection of oxytocin 20 U without increasing blood loss,having less impact on hemodynamics at the same time,can be used safely.