Determining the Lowest Effective Oxytocin Infusion Dose to Maintain Uterine Contraction in Women Having Cesarean Delivery During Labor

What this Trial Is About

Researchers are evaluating the minimal effective dose of oxytocin infusion needed to maintain strong uterine contractions in women undergoing cesarean delivery after labor that was induced or augmented. Oxytocin is commonly used to help the uterus contract and reduce blood loss after delivery. This study uses a dose-finding method where each patients oxytocin dose depends on the uterine response of the previous patient, aiming to identify the dose effective in 90% of patients ED90. The study is a prospective, double-blinded clinical trial where patients, anesthesiologists, and obstetricians do not know the oxytocin dose given. Oxytocin will be infused at varying rates ranging from 4 IUh to 36 IUh, prepared in a 1-liter bag of Ringers lactate infused at 125 mlh. The infusion dose for each new patient is adjusted up or down based on the uterine tone observed in the prior patient. Participants will be monitored for uterine tone up to 2 hours after surgery in the post anesthetic care unit. Researchers will also assess blood loss, need for blood transfusions, bleeding episodes, and additional uterotonic medication use within 24 hours postpartum. Safety will be checked by measuring vital signs and heart rhythm, along with symptoms like nausea, vomiting, chest pain, shortness of breath, and headache during the first 2 hours after delivery. The study follows patients until discharge from the care unit.

Oxytocin Maintenance Infusion in Labouring Women Undergoing Cesarean Delivery: an Up-down Sequential Allocation Study