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Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage
Objective. To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units. Study Design. Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mea...
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Published in: | Journal of Pregnancy 2014-01, Vol.2014 (2014), p.24-27 |
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creator | McKenna, David S. Sonek, Jiri Rudinsky, Kari |
description | Objective. To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units. Study Design. Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mean change was compared by Student’s t -test. The best fit polynomial was analyzed for trends between the two time frames. Women who received blood transfusions were excluded. Results. 73/3564 (2.0%) women received blood transfusions in the pre group and 64/3295 (1.9%) women in the post group, P = 0.8 . Mean hemoglobin change ± standard deviation was 1.53 ± 0.03 g/dL for pre versus 1.52 ± 0.05 g/dL for post, P = 0.68 . 1003/3114 (32.2%) in the pre group had a hemoglobin decrease of ≥2 g/dL compared to 918/2895 (31.7%) in the post group, P = 0.7 . 261/3114 (8.4%) in the pre group had a hemoglobin decrease of ≥3 g/dL compared to 252/2895 (8.7%), P = 0.7 . There were no significant trends between the two time frames. Conclusion. The change in the dose of PP oxytocin did not result in an increase in postpartum hemorrhage or an increase in the need for blood transfusion. |
doi_str_mv | 10.1155/2014/157625 |
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To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units. Study Design. Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mean change was compared by Student’s t -test. The best fit polynomial was analyzed for trends between the two time frames. Women who received blood transfusions were excluded. Results. 73/3564 (2.0%) women received blood transfusions in the pre group and 64/3295 (1.9%) women in the post group, P = 0.8 . Mean hemoglobin change ± standard deviation was 1.53 ± 0.03 g/dL for pre versus 1.52 ± 0.05 g/dL for post, P = 0.68 . 1003/3114 (32.2%) in the pre group had a hemoglobin decrease of ≥2 g/dL compared to 918/2895 (31.7%) in the post group, P = 0.7 . 261/3114 (8.4%) in the pre group had a hemoglobin decrease of ≥3 g/dL compared to 252/2895 (8.7%), P = 0.7 . There were no significant trends between the two time frames. Conclusion. The change in the dose of PP oxytocin did not result in an increase in postpartum hemorrhage or an increase in the need for blood transfusion.</description><identifier>ISSN: 2090-2727</identifier><identifier>EISSN: 2090-2735</identifier><identifier>DOI: 10.1155/2014/157625</identifier><identifier>PMID: 24868465</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Limiteds</publisher><subject>Adult ; Blood transfusion ; Blood Transfusion - statistics & numerical data ; Clinical Protocols - standards ; Clinical Study ; Cohort Studies ; Dosage and administration ; Female ; Hemoglobins - analysis ; Hemorrhage ; Humans ; Management ; Oxytocics - administration & dosage ; Oxytocin ; Oxytocin - administration & dosage ; Patient Safety ; Postnatal care ; Postpartum Hemorrhage - blood ; Postpartum Hemorrhage - prevention & control ; Postpartum Hemorrhage - therapy ; Pregnancy ; Retrospective Studies ; Risk factors ; Safety and security measures ; Treatment Outcome ; Women patients</subject><ispartof>Journal of Pregnancy, 2014-01, Vol.2014 (2014), p.24-27</ispartof><rights>Copyright © 2014 David S. McKenna et al.</rights><rights>COPYRIGHT 2014 John Wiley & Sons, Inc.</rights><rights>Copyright © 2014 David S. McKenna et al. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a670t-926e09e694d5f9aeea3d9ad223ed269d0a72e581b38b2463dbd989c33c39f16c3</citedby><cites>FETCH-LOGICAL-a670t-926e09e694d5f9aeea3d9ad223ed269d0a72e581b38b2463dbd989c33c39f16c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020156/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020156/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,37013,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24868465$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Keelan, Jeffrey</contributor><creatorcontrib>McKenna, David S.</creatorcontrib><creatorcontrib>Sonek, Jiri</creatorcontrib><creatorcontrib>Rudinsky, Kari</creatorcontrib><title>Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage</title><title>Journal of Pregnancy</title><addtitle>J Pregnancy</addtitle><description>Objective. To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units. Study Design. Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mean change was compared by Student’s t -test. The best fit polynomial was analyzed for trends between the two time frames. Women who received blood transfusions were excluded. Results. 73/3564 (2.0%) women received blood transfusions in the pre group and 64/3295 (1.9%) women in the post group, P = 0.8 . Mean hemoglobin change ± standard deviation was 1.53 ± 0.03 g/dL for pre versus 1.52 ± 0.05 g/dL for post, P = 0.68 . 1003/3114 (32.2%) in the pre group had a hemoglobin decrease of ≥2 g/dL compared to 918/2895 (31.7%) in the post group, P = 0.7 . 261/3114 (8.4%) in the pre group had a hemoglobin decrease of ≥3 g/dL compared to 252/2895 (8.7%), P = 0.7 . There were no significant trends between the two time frames. Conclusion. The change in the dose of PP oxytocin did not result in an increase in postpartum hemorrhage or an increase in the need for blood transfusion.</description><subject>Adult</subject><subject>Blood transfusion</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Clinical Protocols - standards</subject><subject>Clinical Study</subject><subject>Cohort Studies</subject><subject>Dosage and administration</subject><subject>Female</subject><subject>Hemoglobins - analysis</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Management</subject><subject>Oxytocics - administration & dosage</subject><subject>Oxytocin</subject><subject>Oxytocin - administration & dosage</subject><subject>Patient Safety</subject><subject>Postnatal care</subject><subject>Postpartum Hemorrhage - blood</subject><subject>Postpartum Hemorrhage - prevention & control</subject><subject>Postpartum Hemorrhage - therapy</subject><subject>Pregnancy</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Safety and security measures</subject><subject>Treatment Outcome</subject><subject>Women patients</subject><issn>2090-2727</issn><issn>2090-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNqNk81rFDEYhwdRbKk9eZcBQUTZNl_zkUuhtNVWil1QwVvIJG92s8wma5Jp3f_erFPXXfDg5DCTd548JO_8piheYnSCcVWdEoTZKa6amlRPikOCOJqQhlZPt8-kOSiOY1ygfLEWI0yeFweEtXXL6uqw-H5lDKgUS29KWX6Gh3IqkwWXyi_SQFpPLoO9B1fe_Vwnr6wrL320blZOg89z35felVMf00qGNCzLa1j6EOZyBi-KZ0b2EY4f70fFtw9XXy-uJ7d3H28uzm8nsm5QmnBSA-JQc6YrwyWApJpLTQgFTWqukWwIVC3uaNsRVlPdad5yRami3OBa0aPiZvRqLxdiFexShrXw0orfBR9mIm_Nqh5E1ekGA20bzgwzrWpJXaGOyq7jRBKGsutsdK2Gbgla5TYE2e9J9984Oxczfy8Yyt-hqrPg7aMg-B8DxCSWNiroe-nAD1HgiiKKOW-ajL4e0ZnMW7PO-GxUG1ycM4IpoYziTJ38g8pDw9Iq78DYXN9b8GZnwRxkn-bR90Oy3sV98P0IquBjDGC2x8RIbKIlNtESY7Qy_Wq3M1v2T5Ay8G4E5tZp-WD_zwYZASN3YEYaTDPwaQSkDTZZsfBDcDlFYrrpM87pQGhUYiL-lsbazoSJ_DP8Ask88Ls</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>McKenna, David S.</creator><creator>Sonek, Jiri</creator><creator>Rudinsky, Kari</creator><general>Hindawi Limiteds</general><general>Hindawi Publishing Corporation</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>188</scope><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20140101</creationdate><title>Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage</title><author>McKenna, David S. ; Sonek, Jiri ; Rudinsky, Kari</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a670t-926e09e694d5f9aeea3d9ad223ed269d0a72e581b38b2463dbd989c33c39f16c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Blood transfusion</topic><topic>Blood Transfusion - statistics & numerical data</topic><topic>Clinical Protocols - standards</topic><topic>Clinical Study</topic><topic>Cohort Studies</topic><topic>Dosage and administration</topic><topic>Female</topic><topic>Hemoglobins - analysis</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Management</topic><topic>Oxytocics - administration & dosage</topic><topic>Oxytocin</topic><topic>Oxytocin - administration & dosage</topic><topic>Patient Safety</topic><topic>Postnatal care</topic><topic>Postpartum Hemorrhage - blood</topic><topic>Postpartum Hemorrhage - prevention & control</topic><topic>Postpartum Hemorrhage - therapy</topic><topic>Pregnancy</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Safety and security measures</topic><topic>Treatment Outcome</topic><topic>Women patients</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McKenna, David S.</creatorcontrib><creatorcontrib>Sonek, Jiri</creatorcontrib><creatorcontrib>Rudinsky, Kari</creatorcontrib><collection>Airiti Library</collection><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of Pregnancy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McKenna, David S.</au><au>Sonek, Jiri</au><au>Rudinsky, Kari</au><au>Keelan, Jeffrey</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage</atitle><jtitle>Journal of Pregnancy</jtitle><addtitle>J Pregnancy</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>2014</volume><issue>2014</issue><spage>24</spage><epage>27</epage><pages>24-27</pages><issn>2090-2727</issn><eissn>2090-2735</eissn><abstract>Objective. To determine if there was an increase in postpartum (PP) hemorrhage after decreasing the PP oxytocin dose from 40 to 30 units. Study Design. Retrospective cohort study comparing 8 months before to 8 months after the change. PP day 1 hemoglobin was subtracted from admission hemoglobin. Mean change was compared by Student’s t -test. The best fit polynomial was analyzed for trends between the two time frames. Women who received blood transfusions were excluded. Results. 73/3564 (2.0%) women received blood transfusions in the pre group and 64/3295 (1.9%) women in the post group, P = 0.8 . Mean hemoglobin change ± standard deviation was 1.53 ± 0.03 g/dL for pre versus 1.52 ± 0.05 g/dL for post, P = 0.68 . 1003/3114 (32.2%) in the pre group had a hemoglobin decrease of ≥2 g/dL compared to 918/2895 (31.7%) in the post group, P = 0.7 . 261/3114 (8.4%) in the pre group had a hemoglobin decrease of ≥3 g/dL compared to 252/2895 (8.7%), P = 0.7 . There were no significant trends between the two time frames. Conclusion. The change in the dose of PP oxytocin did not result in an increase in postpartum hemorrhage or an increase in the need for blood transfusion.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Limiteds</pub><pmid>24868465</pmid><doi>10.1155/2014/157625</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Blood transfusion Blood Transfusion - statistics & numerical data Clinical Protocols - standards Clinical Study Cohort Studies Dosage and administration Female Hemoglobins - analysis Hemorrhage Humans Management Oxytocics - administration & dosage Oxytocin Oxytocin - administration & dosage Patient Safety Postnatal care Postpartum Hemorrhage - blood Postpartum Hemorrhage - prevention & control Postpartum Hemorrhage - therapy Pregnancy Retrospective Studies Risk factors Safety and security measures Treatment Outcome Women patients |
title | Effects of a New Patient Safety-Driven Oxytocin Dosing Protocol on Postpartum Hemorrhage |
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