Chapter 20 - Oxytocin use and dosage during cesarean section

Summary

The use and dosage of oxytocin during cesarean section has been increasingly controversial in recent years and traditional practice has been challenged. A synthetic form of oxytocin is widely used to augment labor, to prevent uterine atony, or to treat established postpartum hemorrhage. Postpartum hemorrhage (PPH) due to uterine atony is a frequently encountered complication of birth and is a leading cause of maternal death. Various studies have examined the hemodynamic effects of oxytocin in parturients. Oxytocin is a drug commonly associated with side effects, particularly hypotension, and has been implicated as being a factor in several known maternal deaths. The potential advantages of an oxytocin infusion at cesarean section are that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period when most primary hemorrhages occur. Clinical studies show significant and progressive depression of uterine contractility with all volatile anesthetics.