Objective: To evaluate and compare the efficacy, haemodynamic stability and adverse effects of oxytocin 2 units bolus followed by infusion at 10 units/hour versus oxytocin 5units bolus followed by infusion at 10 units/hour for prevention of PPH in patients posted for elective caesarean section.

Method: The study was conducted in 80 parturients divided in two groups scheduled to undergo elective Caesarean Section under spinal anaesthesia. Post baby delivery Group I patients received oxytocin bolus of 2 units diluted in 5ml normal saline given over 10 seconds and Group II patients received oxytocin bolus of 5 units followed by oxytocin infusion at the rate of 10 U/h in both groups.. HR and NIBP were recorded till the end of surgery. Any need for supplemental uterotonic or adverse effects was noted

Results: Heart rate response was less in Group I (2 units bolus) patients compared to Group II.

The drop in blood pressure in Group I was between 4-8 minutes and in Group II was between 8-20minutes which was a statistically significant different

Both the groups attained a well contracted uterus at approximately 20 minute .The incidence of adverse effects were less in Group I.

Conclusions: From our study we conclude that slow i.v injection of 2 units bolus dose of oxytocin followed by 10 units per hour infusion for 2 hours is sufficient enough for prevention of postpartum haemorrhage with minimal alterations in hemodynamic variables like heart rate and blood pressure and less adverse effects.

Keywords: oxytocin, Post partum haemorrhage.

1. Carroli G, Cuesta C, Abalos E, et al. Epidemiology of postpartum hemorrhage: a systematic review. Best Pract Res Clin Obstet Gynaecol 2008; 22: 999-1012.
2. Khan KS, Wojdyla D, Say L, et WHO analysis of causes of maternal death: a systematic review. Lancet 2006; 367: 1066-74.
3. United Nations. Millennium Development Goals. New York: United Nations; 2000. Available at: http://www.un.org/milleniumgoal

Dr Priyanka Dhankhar

Consultant Anaesthetist Sikar