Evidence map›Paper›PMID 28212181›Full record

Trial reportAnesthesia and analgesia2017

Effect of a High-Rate Versus a Low-Rate Oxytocin Infusion for Maintaining Uterine Contractility During Elective Cesarean Delivery: A Prospective Randomized Clinical Trial.

Adrienne Duffield, Christine McKenzie, Brendan Carvalho, Bharathi Ramachandran, Victoria Yin, Yasser Y El-Sayed, Edward T Riley, Alexander J Butwick

Abstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Anesthesia and analgesia, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Prophylactic Dose of Oxytocin for Uterine Atony during Caesarean Delivery: A Systematic Review.International journal of environmental research and public health · 2021
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  8. The EDBMC pregnancy and childbirth · 2019
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  9. Oxytocin protocols during Cesarean delivery: optimizing the tone zone.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Adrienne DuffieldFrom the *Department of Anesthesiology, Perioperative, and Pain Medicine and †Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
Christine McKenzie
Brendan Carvalho
Bharathi Ramachandran
Victoria Yin
Yasser Y El-Sayed
Edward T Riley
Alexander J Butwick

Funding

Postpartum Hemmorrhage and Anemia: Epidemiologic and Cost-Effectiveness AnalysesK23HD070972 · NICHD · STANFORD UNIVERSITY · PI BUTWICK, ALEXANDER JAMES · 2013 to 2017
$699k
NICHD NIH HHS K23 HD070972
6 · The paper itself

Abstract

backgroundOxytocin is routinely used as prophylaxis against uterine atony. During elective cesarean delivery (CD), an oxytocin bolus is used to initiate adequate uterine tone, followed by an oxytocin infusion to maintain uterine contractility. However, it is unclear whether oxytocin maintenance infusion rate influences total estimated blood loss (EBL).

methodsWe performed a prospective, randomized, double-blind trial in 51 women undergoing elective CD. Women were randomly assigned to receive an oxytocin maintenance infusion of 2.5 or 15 U/h. All women received an oxytocin 1 U bolus to initiate adequate uterine tone. The primary outcome was EBL. EBL values between groups were compared using a Mann-Whitney U test; P < .05 as statistically significant. The median EBL difference with 95% confidence intervals was also calculated. Secondary outcomes included adequacy of uterine tone, use of additional uterotonics, and oxytocin-related side effects, including hypotension.

resultsOf 51 women, 24 received a low-rate infusion and 27 received a high-rate infusion. Median (interquartile range) EBL values in the low-rate and high-rate groups were 634 (340-886) mL versus 512 (405-740) mL, respectively (P = .7). The median difference in EBL between groups was 22 mL; 95% confidence interval = -158 to 236 mL. The rate of postpartum hemorrhage did not differ between groups (low-rate group: 4/24 [16.7%] versus high-rate group: 4/26 [15.4%]). There were no between-group differences over time (first 20 minutes after commencing infusion) in the incidence of adequate uterine tone (P = .72) or hypotension (P = .32).

conclusionsAmong women undergoing elective CD receiving an oxytocin maintenance infusion, EBL and uterine tone did not differ between women receiving 2.5 U/h oxytocin and those receiving 15 U/h oxytocin. Our findings suggest that efficacy can be obtained with a low oxytocin maintenance infusion rate; however, dose-finding studies are needed to determine the infusion rate that optimizes drug efficacy while minimizing side effects.

Indexed as

AdultCesarean SectionDose-Response Relationship, DrugDouble-Blind MethodElective Surgical ProceduresFemaleHumansInfusions, IntravenousOxytocicsOxytocinPregnancyProspective StudiesTreatment OutcomeUterine ContractionOxytocicsOxytocin

Identifiers

PMID28212181
PMCPMC5319709

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.