American Journal of Obstetrics & Gynecology
Volume 204, Issue 1 , Pages 56.e1-56.e6, January 2011

Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony

Presented as an abstract at the 57th Annual Scientific Meeting of the Society for Gynecologic Investigation, Orlando, FL, March 24-27, 2010.

  • Chad A. Grotegut, MD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
    • ,
  • Michael J. Paglia, MD, PhD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger Medical Center, Danville, PA
    • ,
  • Lauren N.C. Johnson, MD

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
    • ,
  • Betty Thames, RN, BS

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC
    • ,
  • Andra H. James, MD, MPH

      Affiliations

    • Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC

Received 3 May 2010; received in revised form 7 July 2010; accepted 16 August 2010. published online 08 November 2010.

Objective

We sought to determine if women with severe postpartum hemorrhage (PPH) secondary to uterine atony received greater amounts of oxytocin during labor compared to women without PPH.

Study Design

Subjects with severe PPH secondary to uterine atony, who received a blood transfusion, were compared to matched controls. Total oxytocin exposure was calculated as the area under the concentration curve (mU/min*min). Variables were compared using paired t test, χ2, and logistic regression.

Results

Women with severe PPH had a mean oxytocin area under the curve of 10,054 mU compared to 3762 mU in controls (P < .001). After controlling for race, body mass index, admission hematocrit, induction status, magnesium therapy, and chorioamnionitis using logistic regression, oxytocin area under the curve continued to predict severe PPH.

Conclusion

Women with severe PPH secondary to uterine atony were exposed to significantly more oxytocin during labor compared to matched controls.

Key words: desensitization, oxytocin, oxytocin receptor, postpartum hemorrhage, uterine atony

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 Funding was provided by National Institutes of Health Grant no. K12-HD-043446 (C.A.G.).

 Reprints not available from the authors.

 Cite this article as: Grotegut CA, Paglia MJ, Johnson LNC, et al. Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. Am J Obstet Gynecol 2011;204:56.e1-6.

PII: S0002-9378(10)01026-4

doi:10.1016/j.ajog.2010.08.023

American Journal of Obstetrics & Gynecology
Volume 204, Issue 1 , Pages 56.e1-56.e6, January 2011

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