The risk of obstetric hemorrhage is increased with exposure to intrapartum oxytocin for longer than 12 hours, suggest a new study presented at the annual meeting of the American College of Obstetricians and Gynecologists (ACOG) held in San Diego earlier this month.¹

In this retrospective analysis, 2232 women who required intrapartum exogenous oxytocin for induction or augmentation of labor, from January 2018 to December 2019, were examined to assess the impact on prolonged exposure to intrapartum oxytocin on the amount of blood loss, obstetric hemorrhage (blood loss ≥1000mL) or related maternal morbidity. Based on the duration of exposure to intrapartum oxytocin, the participants were grouped into two: <12 hours or ≥12 hours of exposure.

Women with prolonged exposure to oxytocin i.e., for 12 hours or longer, experienced 26% higher mean quantitative blood loss. They had a 52% higher risk of having obstetric hemorrhage compared to the women in the less than 12 hours group. But the participants in this group were not at risk of morbidity due to bleeding.

Women who had a vagina delivery were at a 21% increased risk of quantitative blood loss and 47% increased risk of obstetric hemorrhage, if they were exposed to intrapartum oxytocin for 12 hours or more. No significant differences were observed among the cesarean deliveries regarding the outcomes.

Obstetric hemorrhage is a largely preventable complication. Hence, clinical decision-making should take into account the risks and benefits of the individual decision for better patient outcomes.

Reference

1. Alexander M, et al. Prolonged duration of oxytocin exposure increases obstetric hemorrhage risk [A135]. Obstetrics & Gynecology: May 2022 - Volume 139 - Issue - p 39S-40S doi: 10.1097/01.AOG.0000825820.92319.9e.