Pre-incisional Oxytocin infusion in elective cesarean section delivery, maternal and neonatal outcome

Background: Best timing for giving prophylactic oxytocin during cesarean section (CS) to prevent post-partum hemorrhage (PPH) is still a debatable issue.
Objectives: Assess maternal and neonatal effects of starting prophylactic oxytocin infusion just before uterine incision during CS.
Methods: This study is a randomized controlled trial, evaluating best timing of oxytocin administration in cesarean deliveries as regard amount of intraoperative and postoperative estimated maternal blood loss, also evaluated change of pre-operative to post-operative hemoglobin levels, intraoperative maternal nausea and vomiting and immediate postpartum neonatal condition. One hundred and fifty patients had done pre-labor cesarean section, half of participants received oxytocin immediately before uterine incision and the other half received oxytocin in the third stage of labor. The study hypothesized that administering oxytocin immediately before uterine incision, resulted in less overall maternal blood loss, better maternal and neonatal outcome.
Results: Results were pooled, mean, standard deviation, P value and 95% confidence intervals (CI) were calculated. There was a significant reduction in the need for additional uterotonics and also reduced intra-operative and postoperative blood loss and need for blood transfusion, when oxytocin was given immediately before uterine incision versus after fetal delivery.
Conclusion: Immediately pre-incisional oxytocin infusion was superior to post-placental delivery oxytocin infusion as regard additional use of ecbolics in elective cesarean sections, further studies with large sample sizes are needed for further evaluation of other maternal and neonatal parameters.