Oxytocin at Elective Cesarean Delivery: A Dose-Finding Study in Pregnant People With Twin Pregnancy
Authors' conclusion
Our results demonstrated that people with twin pregnancy require a much higher dose of oxytocin than those with singleton pregnancies.
Study context
- Population
- Twin pregnancy ≥36 weeks undergoing elective cesarean delivery under neuraxial anesthesia, without additional PPH risk factors
- Participants
- 30 participants
- Outcome
- Satisfactory uterine tone assessed by the operating obstetrician; ED90 of oxytocin bolus
- Follow-up
- 2 minutes after completion of oxytocin bolus
Methodological detailsdouble-blind, biased coin up-down method
- Double-blind
- Biased coin up-down method
Main finding
As reported in the abstract
ED90 of oxytocin
ED90, isotonic regression
4.38 IU
95% CI 3.68–4.86 IU
ED90, Dixon-Mood
3.41 IU
95% CI 2.83–3.98 IU
Secondary outcomes
Inadequate tone at 2 min requiring rescue uterotonic drugs · 2 minutes
- Patients requiring rescue uterotonics
- 7
Estimated blood loss (change in 24-hour hematocrit)
- Median (IQR 732-1462 mL)
- 1031 mL
Safety
Adverse effects after oxytocin
- Hypotension
- 27%
- Nausea
- 30%
- Vomiting
- 17%
Original publication
Oxytocin at Elective Cesarean Delivery: A Dose-Finding Study in Pregnant People With Twin Pregnancy. Anesth Analg. Published 8 December 2022. doi:10.
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