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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
Main Authors: McKenna, David S., Sonek, Jiri, Rudinsky, Kari
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Language:English
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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.
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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 &amp; numerical data ; Clinical Protocols - standards ; Clinical Study ; Cohort Studies ; Dosage and administration ; Female ; Hemoglobins - analysis ; Hemorrhage ; Humans ; Management ; Oxytocics - administration &amp; dosage ; Oxytocin ; Oxytocin - administration &amp; dosage ; Patient Safety ; Postnatal care ; Postpartum Hemorrhage - blood ; Postpartum Hemorrhage - prevention &amp; 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 &amp; 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 . 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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 . 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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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