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Oxytocin is widely used to prevent postpartum hemorrhage (PPH), but optimal dosing is unknown, particularly for vaginal birth. Researchers in Alabama conducted a single-center randomized trial to evaluate the efficacy of 10, 40, or 80 units of intravenous oxytocin (given during the hour after placental delivery) for PPH prophylaxis in 1798 vaginal deliveries at ≥24 weeks' gestation.
Uterine atony or hemorrhage requiring any treatment (the primary outcome) occurred in about 7% of participants. Compared with the 10-unit dose, 80 and 40 units of oxytocin did not significantly lower risk for the primary outcome. However, use of 80 units lowered both the likelihood of a drop in hematocrit >6% and the need for additional oxytocin (i.e., of treatme…