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Oxytocin Abuse and Postpartum Hemorrhage

Open Journal of Obstetrics and Gynecology 2022年第12期12卷 1320-1327页

作者： Loutfi Guennoun Abdelmounaim Mohammed Khouchoua Nouha Nhiri Naouale Biougnache Mohamed Adnane Rhaidouni Ouassila Laouji Fatima El Hadraoui safae habib rabbi Omar El Ayoubi Omar Alaoui Samir Messnan Said Lafkir The Head of Pol Mother and Child Department in Sidi Said Hospital Meknes Morocco Prefectorial Epidemiology Cell Ministry of Health Meknes Morocco Gynecology and Obstetrics Department Pagnon Hospital Meknes Morocco The Head Midwives of Two Teams in Pagnon Hospital Meknes Morocco Master in Communication Moulay Ismail University Meknes Morocco Medical Administration and Epidemiological Services Meknes Morocco

Among the most consolidated dogmas in obstetrics, we have the essential role of oxytocin during: labor by regulating, consolidating uterine contractions, by supporting the expulsive efforts of the patient during childbirth and after childbirth by preventing postpartum hemorrhage. But what challenged us to conduct our study is the large and increasing number of surgical operations for postpartum hemorrhage in patients who received oxytocin during labor. We assumed that the generalization use of oxytocin in all patients during labor is probably responsible of this increasing rate of incidents. To verify this assumption, we carried out a prospective randomized comparative study, involving 3990 pregnant patients admitted at the start of labor at term, with no contraindication for giving birth by normal ways, during a period of 10 months (January-October 2022). The patients have been divided into 2 groups. The first group comprises 1991 patients who were placed on admission on a glucose serum infusion with 4 ampoules of a non-anticholinergic musculotropic antispasmodic: “Hydrated phloroglucinol + trimethylphloroglucinol” (Each ampoule contains 40 mg of hydrated phloroglucinol and 0.04 mg of trimethylphloroglucinol) instead of receiving oxytocin during the active phase of their labor and a second group consisting of 1999 patients who received oxytocin during the active phase of their labor. The results were very surprising and contrary to the already consolidated evidence in our specialty. Indeed, the rate of postpartum hemorrhages was 10 patients (0.5%) in the 1st group vs 30 patients (1.5%) in the 2nd group, 9 patients (0.4%) presented fetal heart rate abnormalities in the 1st group vs 90 (4.5%) in the 2nd group, 8 cases (0.4%) of dynamic dystocia in the 1st group vs 132 cases (6.6%) in the 2nd group and 99 caesareans (5%) in the 1st group vs 299 (15%) in the 2nd group. Against all expectations the results were very surprising, with more details in the article.

关键词： Oxytocin Antispasmodic Postpartum Hemorrhage Uterine Inertia Dynamic Dystocia Cesarean Section Abnormal Fetal Heart Rate

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Oxytocin and Uterine Atony during Cesarean Section

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Open Journal of Obstetrics and Gynecology 2021年第6期11卷 815-822页

作者： Loutfi Guennoun Abdelmounaim A. Rjafallah N. Nhiri N. Biougnache R. Benafitou R. Barka Y. Bouferma S. habib rabbi O. El Ayoubi O. Alaoui S. Mesnane M. Khouchoua S. Lafkir Gynecology and Obstetrics Department Sidi Said Hospital Meknes Morocco Gynecology and Obstetrics Department Pagnon Hospital Meknes Morocco Resuscitation Anesthesia Department Pagnon Hospital Meknes Morocco Head Nurse of Gynecology and Obstetrics Department Pagnon Hospital Meknes Morocco Head of the Admissions Department Sidi Said Hospital Meknes Morocco Master in Communication Moulay Ismail Meknes University Meknes Morocco Medical Administration and Epidemiological Services Meknes Morocco

In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical supports, to make the exercise of our specialty as stripped of pitfalls as possible. Our work is summarized in a prospective comparative study, aimed at evaluating the existence or not of a difference between the administration of oxytocin just before the hysterotomy in a cesarean section and its administration after fetal extraction. We used a set of criteria to include patients in our study. This study took place over a period of one year (2020) in the Mother and Child regional center, in Meknes Imperial city, Morocco, involving a total number of 364 patients. With a group A comprising 176 patients 48% (176/364) who received oxytocin just before the hysterotomy and a group B of 188 patients 52% (188/364) who received it classically after fetal extraction. The difference was very significant as detailed in the article. Conclusion: the very convincing results of our study and the difference between the two groups, allowed us to demonstrate the effectiveness of our process and to endorse its use in our routine practice, with the perspective of conducting a prospective randomized study on a larger series.

关键词： Oxytocin Cesarean Section Uterine Atony Postpartum Hemorrhage

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Oxytocin and Uterine Atony during Cesarean Section

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Open Journal of Obstetrics and Gynecology（妇产科期刊） 2021年第6期

作者： Loutfi Guennoun Abdelmounaim A. Rjafallah N. Nhiri N. Biougnache R. Benafitou R. Barka Y. Bouferma S. habib rabbi O. El Ayoubi O. Alaoui S. Mesnane M. Khouchoua S. Lafkir

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