Oxytocin Dosing at Planned Cesarean Section and Anemia
Kľúčové slová
Abstrakt
Popis
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.
Termíny
| Naposledy overené: | 01/31/2019 |
| Prvý príspevok: | 07/31/2017 |
| Odhadovaná registrácia bola odoslaná: | 11/27/2017 |
| Prvý príspevok: | 12/03/2017 |
| Posledná aktualizácia bola odoslaná: | 02/18/2019 |
| Posledná aktualizácia bola zverejnená: | 02/20/2019 |
| Aktuálny dátum začatia štúdie: | 02/28/2019 |
| Odhadovaný dátum dokončenia primárneho okruhu: | 02/29/2020 |
| Odhadovaný dátum dokončenia štúdie: | 02/29/2020 |
Stav alebo choroba
Intervencia / liečba
Drug: Oxytocin
Fáza
Skupiny zbraní
| Arm | Intervencia / liečba |
|---|---|
| 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. |
Kritériá oprávnenosti
| Vek vhodný na štúdium | 18 Years To 18 Years |
| Pohlavia vhodné na štúdium | Female |
| Prijíma zdravých dobrovoľníkov | Áno |
| Kritériá | 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. |
Výsledok
Primárne výstupné opatrenia
1. Blood loss in postpartum period defined by grams/hour [3-4 days after delivery]
Opatrenia sekundárnych výsledkov
1. Change in Hemoglobin [24 hours]
2. Change in Hematocrit [24 hours]
3. Length of hospital stay [3-4 days after delivery]
4. Need for additional uterotonics [24 hours after delivery]
5. Continuation of breastfeeding [6 weeks]
6. Quantity of narcotic pain medications [3-4 days after delivery]
7. Attendance at post-partum visit [6 weeks]
8. Post-partum complications [6 weeks]
9. Need for blood transfusion [3-4 days after delivery]
10. Edinburgh post-partum depression scale >10 [6 weeks]
