The Effect of Intrauterine Oxytocin-Soaked Gauze on Postoperative Bleeding in Cesarean Section: A Double-Blind Randomized Clinical Trial

Intrauterine oxytocin-soaked gauze during cesarean delivery significantly reduces blood loss and supports maternal stability without added complications.

Summary and findings

This study evaluated the effect of intrauterine oxytocin-soaked gauze on blood loss and hemodynamic stability in 120 women undergoing elective cesarean delivery. The oxytocin group demonstrated lower intraoperative blood loss compared to saline and control groups. No significant differences in heart rate or serious adverse events were observed.

Abstract

<title>Abstract</title> <p>Background Postpartum hemorrhage remains a major cause of maternal morbidity following cesarean delivery. Although intravenous oxytocin is standard prophylaxis, systemic adverse effects encourage evaluation of alternative adjunctive delivery methods. This study assessed whether intrauterine oxytocin-soaked gauze reduces blood loss and improves hemodynamic stability. Methods In this double-blind randomized trial, 120 term women undergoing elective cesarean delivery under spinal anesthesia were allocated to oxytocin‐soaked gauze (n = 40), saline‐soaked gauze (n = 43), or dry gauze control (n = 37). The primary outcome was total intraoperative blood loss. Secondary outcomes included changes in hemoglobin, hematocrit, blood pressure, heart rate, temperature, and oxygen saturation. Appropriate parametric or nonparametric tests were applied with a significance threshold of 0.05. Results Median blood loss was significantly lower in the oxytocin group (440 mL [IQR 350–530]) compared with saline (540 mL [420–625]) and control (625 mL [475–700]; p < 0.001). Hematocrit reduction was attenuated (–1.56 ± 0.81% vs. − 2.46 ± 1.37% and − 3.62 ± 1.23%; p = 0.0003), while hemoglobin changes were similar (p = 0.976). Systolic and diastolic blood pressure remained stable in the oxytocin group but declined in comparators (p < 0.05). No significant differences in heart rate or serious adverse events were observed. Conclusion Intrauterine oxytocin-soaked gauze during cesarean delivery reduces surgical blood loss and supports maternal hemodynamic stability without added complications. Larger multicenter studies are warranted to confirm these findings.</p>

Limitations

Not reported in abstract.

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