TITLE:
Oxytocin Abuse and Postpartum Hemorrhage
AUTHORS:
Loutfi Guennoun Abdelmounaim, Mohammed Khouchoua, Nouha Nhiri, Naouale Biougnache, Mohamed Adnane Rhaidouni, Ouassila Laouji, Fatima El Hadraoui, Safae Habib Rabbi, Omar El Ayoubi, Omar Alaoui, Samir Messnan, Said Lafkir
KEYWORDS:
Oxytocin, Antispasmodic, Postpartum Hemorrhage, Uterine Inertia, Dynamic Dystocia, Cesarean Section, Abnormal Fetal Heart Rate
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.12 No.12,
December
30,
2022
ABSTRACT: Among the most consolidated dogmas in obstetrics, we have the essential role
of oxytocin during: labor by regulating, consolidating uterine contractions, by
supporting the expulsive efforts of the patient during childbirth and after childbirth
by preventing postpartum hemorrhage. But what challenged us to conduct our study
is the large and increasing number of surgical operations for postpartum hemorrhage
in patients who received oxytocin during labor. We assumed that the generalization
use of oxytocin in all patients during labor is probably responsible of this increasing
rate of incidents. To verify this assumption, we carried out a prospective randomized
comparative study, involving 3990 pregnant patients admitted at the start of labor
at term, with no contraindication for giving birth by normal ways, during a period
of 10 months (January-October 2022). The patients have been divided into 2 groups.
The first group comprises 1991 patients who were placed on admission on a glucose
serum infusion with 4 ampoules of a non-anticholinergic musculotropic antispasmodic:
“Hydrated phloroglucinol + trimethylphloroglucinol” (Each ampoule contains 40 mg
of hydrated phloroglucinol and 0.04 mg of trimethylphloroglucinol) instead of receiving
oxytocin during the active phase of their labor and a second group consisting of
1999 patients who received oxytocin during the active phase of their labor. The
results were very surprising and contrary to the already consolidated evidence in
our specialty. Indeed, the rate of postpartum hemorrhages was 10 patients (0.5%) in the 1st
group vs 30 patients (1.5%) in the 2nd group, 9 patients (0.4%) presented fetal
heart rate abnormalities in the 1st group vs 90 (4.5%) in the 2nd group, 8 cases
(0.4%) of dynamic dystocia in the 1st group vs 132 cases (6.6%) in the 2nd group
and 99 caesareans (5%) in the 1st group vs 299 (15%) in the 2nd group. Against all
expectations the results were very surprising, with more details in the article.