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Oxytocin Dosing at Planned Cesarean Section and Anemia

يمكن للمستخدمين المسجلين فقط ترجمة المقالات
الدخول التسجيل فى الموقع
يتم حفظ الارتباط في الحافظة
الحالة
الرعاة
Milton S. Hershey Medical Center

الكلمات الدالة

نبذة مختصرة

Patient's with planned cesarean sections will be randomized to receive either standard 20 mU in 1L as a bolus following delivery of the placenta or 20 mu in 1L following delivery of the placenta plus an additional 20 mU in 1L over 8 hours.

وصف

The purpose of this study is to examine the impact of differential dose protocols commonly utilized in the post cesarean period to determine if laboratory definitions of anemia are different. Oxytocin is an antidiuretic hormone that is utilized after delivery of the fetus and placenta to contract the uterus and decrease blood loss both at the time of surgery and in the post-partum period. Here at the Penn State Hershey Medical center the investigators will use 20 units of oxytocin in a 1 L bag of LR in bolus fashion after delivery of the placenta. Other protocols use an extended course of therapy using 20 units of oxytocin in a 1 L bag of LR in a bolus plus an additional 20 units of oxytocin in a 1 L bag of LR over an 8 hour period of time.

We hypothesize that:

- Women who receive the standard 20 mU of oxytocin in 1L of LR in bolus fashion plus 20 mU in 1L over 8 hours will have a decreased reduction in pre-operative vs post-operative hematocrit and hemoglobin versus those that receive 20 mU in 1L of LR.

- Women who receive the standard 20 mU of oxytocin in 1L of LR in bolus fashion plus 20 mU in 1L over 8 hours will have decreased blood loss by weight in the postpartum period compared to patients who receive 20 mU in 1L of LR.

تواريخ

آخر التحقق: 01/31/2019
تم الإرسال لأول مرة: 07/31/2017
تم إرسال التسجيل المقدر: 11/27/2017
أول نشر: 12/03/2017
تم إرسال آخر تحديث: 02/18/2019
آخر تحديث تم نشره: 02/20/2019
تاريخ بدء الدراسة الفعلي: 02/28/2019
تاريخ الإنجاز الأساسي المقدر: 02/29/2020
التاريخ المتوقع لانتهاء الدراسة: 02/29/2020

حالة أو مرض

Blood Loss Anemia
Uterine Atony With Hemorrhage

التدخل / العلاج

Drug: Oxytocin

مرحلة

مرحلة 4

مجموعات الذراع

ذراعالتدخل / العلاج
Placebo Comparator: Control
Patient will receive standard post-partum Oxytocin (20 mU in 1 L LR) and 1 L LR over 8 hours following delivery.
Experimental: Treatment
Patient will receive standard post-partum Oxytocin(20 mU in 1 L LR) an additional 20 mU Oxytocin in 1 L LR over 8 hours following delivery.

معايير الأهلية

الأعمار المؤهلة للدراسة 18 Years إلى 18 Years
الأجناس المؤهلة للدراسةFemale
يقبل المتطوعين الأصحاءنعم
المعايير

Inclusion Criteria:

- Planned cesarean sections for singletons at or greater than 37 weeks gestational age

- Primary or repeat cesarean section will be included

Exclusion Criteria:

- Multiple fetal pregnancies

- Hematologic disorders

- Fetal anomalies

- Pre-eclampsia. These patients are at increased risk of fluid overload and so fluid status may be affected by receiving a second bag of fluid containing oxytocin in the postpartum period.

- Known contraindication to oxytocin

- Hypersensitivity to oxytocin

- Patients who have labored and then proceed with cesarean section for any reason. Patients who have labored have had either intrinsic or extrinsic exposure to oxytocin. These patients may have decreased sensitivity to oxytocin.

النتيجة

مقاييس النتائج الأولية

1. Blood loss in postpartum period defined by grams/hour [3-4 days after delivery]

Measure pads used post-partum

مقاييس النتائج الثانوية

1. Change in Hemoglobin [24 hours]

Pre-op hemoglobin and post-op hemoglobin

2. Change in Hematocrit [24 hours]

Pre-op hematocrit and post-op hematocrit

3. Length of hospital stay [3-4 days after delivery]

Start of surgery to discharge (hours)

4. Need for additional uterotonics [24 hours after delivery]

Use of uterotonics

5. Continuation of breastfeeding [6 weeks]

Is patient breastfeeding at 6 week post-partum visit

6. Quantity of narcotic pain medications [3-4 days after delivery]

Number of narcotic tablets used from time of surgery to discharge

7. Attendance at post-partum visit [6 weeks]

Did patient attend post-partum visit?

8. Post-partum complications [6 weeks]

Did patient have surgical wound infection, endometritis?

9. Need for blood transfusion [3-4 days after delivery]

Did the patient require blood transfusion?

10. Edinburgh post-partum depression scale >10 [6 weeks]

Did the patient score greater than 10 points on Edinburgh post-partum depression scale?

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  • خريطة GPS تفاعلية - ضع علامة على الأعشاب في الموقع (قريبًا)
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اكتب أحد الأعراض أو المرض واقرأ عن الأعشاب التي قد تساعد ، واكتب عشبًا واطلع على الأمراض والأعراض التي تستخدم ضدها.
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