Investigating the Effect of Pulsatile Administration of Oxytocin on the Desensitization of Human Myometrium In-vitro
Status:
Completed
Trial end date:
2015-06-01
Target enrollment:
Participant gender:
Summary
Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide
and is caused most commonly by poor uterine muscle (myometrium) tone after delivery. The
first line agent used in the prevention and treatment of PPH is oxytocin.
Women who require augmentation of labor with intravenous oxytocin because of inadequate labor
progression have been shown to be at increased risk of PPH. Typically, for augmentation of
labor, oxytocin is used as a continuous infusion, with no consensus on the initial dose, its
increments or maximal limit. High concentration continuous oxytocin infusions are not without
theirs risks, which include hyperstimulation, fetal distress, as well as uterine rupture.
Studies have shown the clinical benefits of pulsatile oxytocin delivery for labor induction
and augmentation with regards to requirement of less total oxytocin, similar uterine
contractility and similar rates of caesarean delivery when used for labor induction and
augmentation. However, the rate of PPH as a primary outcome measure has not been
investigated. Therefore we currently do not know the effect of pulsatile oxytocin delivery on
the rate of PPH.
The investigators hypothesize that the effect of myometrial desensitization following
pulsatile oxytocin exposure would be lower when compared to continuous oxytocin exposure.
These results will help in establishing whether myometrial contractility and sensitivity to
oxytocin can be better preserved by delivery of pulsatile oxytocin, rather than continuous
oxytocin for labor induction and augmentation, and thereby result in less PPH.
Phase:
N/A
Details
Lead Sponsor:
Samuel Lunenfeld Research Institute, Mount Sinai Hospital