Side-effects of oxytocin in postpartum hemorrhage: a systematic review and meta-analysis

Department of Obstetrics and Gynecology, Foshan Fosun Chancheng Hospital Foshan 528031, Guangdong, China. Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University Hefei 230032, Anhui, China. Department of Library, The First Affiliated Hospital, College of Medicine, Zhejiang University Hangzhou 310003, Zhejiang, China. Foshan Fetal Medicine Research Institute, Affiliated Foshan Women and Children Hospital, Southern Medical University Foshan 528000, Guangdong, China.

American Journal of Translational Research. 2022;14(3):1934-1951
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Abstract
OBJECTIVE To evaluate the side-effects of oxytocin for the prevention of postpartum hemorrhage (PPH) in randomized controlled trials (RCTs). METHODS Electronic databases (Web of Science, Embase, PubMed, Elsevier ScienceDirect, the Cochrane Library, and ClinicalTrials.gov) were searched from the beginning of indexing to Sep 2021. RCTs comparing oxytocin with non-oxytocin uterotonic agent(s) or non-pharmacologic interventions for the prevention of PPH were eligible. RESULTS Overall, sixty-one RCTs meeting the inclusion criteria were included, involving 68834 participants. Twenty-seven types of side-effects were reported in this study. There were 24, 35, or 2 trials assessed as high medium and low quality, respectively. Compared with non-oxytocin, oxytocin had significantly lower risk for shivering (RR=0.31, 95% CI=0.23-0.41, n=36680), fever (RR=0.27, 95% CI=0.20-0.37, n=34031), and diarrhea (RR=0.48, 95% CI=0.35-0.66, n=30883). Other side-effects were not found associated with oxytocin. CONCLUSION Oxytocin use was association with a significantly lower incidence of shivering, fever, and diarrhea events and did not increase risk of other side-effects during the third stage of labor. These observations may aid obstetricians and gynecologists in weighing up the benefits and risks associated with oxytocin in prevention and treatment of PPH during the third stage of labor.
Study details
Study Design : Systematic Review
Language : eng
Credits : Bibliographic data from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine