Patient's with planned cesarean sections will be randomized to receive either standard 20 mU in 1L as a bolus following delivery of the placenta or 20 mu in 1L following delivery of the placenta plus an additional 20 mU in 1L over 8 hours.
The purpose of this study is to examine the impact of differential dose protocols commonly utilized in the post cesarean period to determine if laboratory definitions of anemia are different. Oxytocin is an antidiuretic hormone that is utilized after delivery of the fetus and placenta to contract the uterus and decrease blood loss both at the time of surgery and in the post-partum period. Here at the Penn State Hershey Medical center the investigators will use 20 units of oxytocin in a 1 L bag of LR in bolus fashion after delivery of the placenta. Other protocols use an extended course of therapy using 20 units of oxytocin in a 1 L bag of LR in a bolus plus an additional 20 units of oxytocin in a 1 L bag of LR over an 8 hour period of time. We hypothesize that: * Women who receive the standard 20 mU of oxytocin in 1L of LR in bolus fashion plus 20 mU in 1L over 8 hours will have a decreased reduction in pre-operative vs post-operative hematocrit and hemoglobin versus those that receive 20 mU in 1L of LR. * Women who receive the standard 20 mU of oxytocin in 1L of LR in bolus fashion plus 20 mU in 1L over 8 hours will have decreased blood loss by weight in the postpartum period compared to patients who receive 20 mU in 1L of LR.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Administration of additional 20 mU Oxytocin
Blood loss in postpartum period defined by grams/hour
Measure pads used post-partum
Time frame: 3-4 days after delivery
Change in Hemoglobin
Pre-op hemoglobin and post-op hemoglobin
Time frame: 24 hours
Change in Hematocrit
Pre-op hematocrit and post-op hematocrit
Time frame: 24 hours
Length of hospital stay
Start of surgery to discharge (hours)
Time frame: 3-4 days after delivery
Need for additional uterotonics
Use of uterotonics
Time frame: 24 hours after delivery
Continuation of breastfeeding
Is patient breastfeeding at 6 week post-partum visit
Time frame: 6 weeks
Quantity of narcotic pain medications
Number of narcotic tablets used from time of surgery to discharge
Time frame: 3-4 days after delivery
Attendance at post-partum visit
Did patient attend post-partum visit?
Time frame: 6 weeks
Post-partum complications
Did patient have surgical wound infection, endometritis?
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Time frame: 6 weeks
Need for blood transfusion
Did the patient require blood transfusion?
Time frame: 3-4 days after delivery
Edinburgh post-partum depression scale >10
Did the patient score greater than 10 points on Edinburgh post-partum depression scale?
Time frame: 6 weeks