4. Conclusion
In this study we evaluated a standard postpartum 30-unit
oxytocin dose versus a 40-unit dose and found there was
no difference in the need for blood transfusion, mean
hemoglobin change, and hemoglobin changes of 2 or 3 g/dL,
demonstrating that the new medication protocol did not
increase the incidence of postpartum blood loss nor number
of blood transfusions despite administering a lower total
dose of oxytocin. The effects of medical errors are far
reaching and costly and have the potential for high liability,
especially when they occur on the labor and delivery unit
[8]. Standardized medication dosing may have a positive
impact on the reduction ofmedical errors.However it should
be emphasized that while standardization can have medical
advantages, there may also be unanticipated disadvantages,
that is, balancing measures.
In the United States the prophylactic use of oxytocin
during the third stage of labor for the prevention of uterine
atony and postpartum hemorrhage is the accepted practice
[9]. Despite this wide spread practice there is insufficient
data and little agreement or evidence to recommend an
optimal dose of oxytocin and 10 to 40 units are usually given
[10, 11]. Recently, Tita et al. compared three different thirdstage
oxytocin doses (80 units, 40 units, or 10 units) and
did not find a difference in the incidence of uterine atony or
postpartum hemorrhage [12]. However the 80-unit dose was
found to reduce the need for treatment of hemorrhage after
the first postpartum hour and fewer women had a decline of
hematocrit of 6% or more [12].
4. Conclusion
In this study we evaluated a standard postpartum 30-unit
oxytocin dose versus a 40-unit dose and found there was
no difference in the need for blood transfusion, mean
hemoglobin change, and hemoglobin changes of 2 or 3 g/dL,
demonstrating that the new medication protocol did not
increase the incidence of postpartum blood loss nor number
of blood transfusions despite administering a lower total
dose of oxytocin. The effects of medical errors are far
reaching and costly and have the potential for high liability,
especially when they occur on the labor and delivery unit
[8]. Standardized medication dosing may have a positive
impact on the reduction ofmedical errors.However it should
be emphasized that while standardization can have medical
advantages, there may also be unanticipated disadvantages,
that is, balancing measures.
In the United States the prophylactic use of oxytocin
during the third stage of labor for the prevention of uterine
atony and postpartum hemorrhage is the accepted practice
[9]. Despite this wide spread practice there is insufficient
data and little agreement or evidence to recommend an
optimal dose of oxytocin and 10 to 40 units are usually given
[10, 11]. Recently, Tita et al. compared three different thirdstage
oxytocin doses (80 units, 40 units, or 10 units) and
did not find a difference in the incidence of uterine atony or
postpartum hemorrhage [12]. However the 80-unit dose was
found to reduce the need for treatment of hemorrhage after
the first postpartum hour and fewer women had a decline of
hematocrit of 6% or more [12].
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