Abstract

Postpartum hemorrhage from uterine atony, a major global and local health burden, remains to be a leading cause of maternal mortality. Intravenous oxytocin infusion has become the conventional first-line drug in the active management of third stage of labor in most countries. This, however, has been associated with refractory uterine atony and major hemodynamic side effects; hence the need to explore on the possibility of a better alternative such as intramyometrial oxytocin administration. Objectives: To compare the efficacy of 10IU of Intramyometrial Oxytocin and 10IU of Intravenous Oxytocin in prevention of Postpartum Haemorrhage during Cesarean Section. Settings and Design: A prospective randomised control study was conducted in the department of obstetrics and gynaecology at R.L Jalappa Hospital, Kolar. Methods and Material: Blood loss was considered as the primary measure variable and uterine tone at 1 min and 5 min of oxytocin administration and diasystolic blood pressure at 1 min and 5 mins post oxytocin administration were secondary outcomes measured. Statistical analysis used: Descriptive analysis was carried out by mean and standard deviation for quantitative variables, frequency and proportion for categorical variables. Data was also represented using appropriate diagrams like bar diagram. Results: A total of 186 subjects were included in the study. A total of 92 intravenous and 94 intramyometrial were included in the final analysis. The mean blood loss in ml patient was 624.78±132.85 in intravenous oxytocin group and it was 455.85 ±119.5 in intramyometrial, with a mean difference of 168.93 (p value < 0.001), which was statistically significant. Conclusions: Intramyometrial oxytocin at the same dose as i.v. administration both initiate contractions at similar intervals post administration. Intramyometrial infusion has a better safety profile when assessed using fall in diastolic blood pressure. It also resulted in lesser blood loss when compare to intravenous oxytocin.

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