Completed RCT investigated feasibility of high vs. low dose oxytocin for post-cesarean hemorrhage prevention

Postpartum hemorrhage (PPH) remains a leading cause of maternal morbidity and mortality worldwide, particularly following cesarean birth. While oxytocin is the first-line uterotonic for PPH prevention, optimal dosing strategies, especially for high-risk scenarios like cesarean sections, are still debated. Current standard-of-care often involves a low-dose regimen, but evidence suggests that higher doses might offer superior uterine contraction and reduced blood loss. However, concerns about potential side effects, such as cardiovascular instability or hyponatremia, necessitate careful evaluation of high-dose protocols. This study addresses the critical gap in understanding the feasibility and comparative safety/efficacy of different oxytocin dosing regimens during cesarean delivery, aiming to inform future clinical guidelines and improve maternal outcomes.

This randomized controlled trial (RCT), NCT05782816, enrolled 170 participants undergoing cesarean birth. The study compared two distinct oxytocin regimens: a standard low-dose protocol and a high-dose protocol. The high-dose arm received oxytocin via a controlled infusion pump, starting at 6 milli-units/min and incrementally increasing by 6 milli-units/min every 20 minutes. The specific maximum infusion rate for the study's high-dose arm was not detailed in the abstract. The primary endpoints were to investigate the feasibility of conducting a larger RCT comparing these dosing strategies and to assess any differences in health outcomes between the two arms, including potential adverse events. The study was completed in June 2025.