Thesis (M.Sc.) -Cairo University, 2023.

Bibliography: pages 87-105.

Background: Cesarean delivery (CD) is commonly performed operation in modern
obstetrics. The risks of cesarean section (CS) include maternal mortality, hemorrhage,
venous thrombosis, infections, and anesthetic complications. Oxytocin is the most
commonly used ecbolic agent during management of atonic postpartum hemorrhage.
Objective: Comparison between maternal and neonatal outcomes following early (after
delivery of shoulder) versus delayed (at 60sec) oxytocin administration in case of delayed
cord clamping in elective cesarean section.
Patients and Methods: A total of 124 pregnant women were enrolled, after consenting
each of them. On the day of the scheduled surgery, participants were randomly and
equally assigned into two equal groups; early oxytocin administration group (oxytocin
was given after delivery of shoulder) and delayed oxytocin administration group
(oxytocin was given after umbilical cord clamping at 60 sec). In both groups we
performed delayed cord clamping at 60 seconds.



Results: Early administration of oxytocin (after delivery of shoulder) compared to late
oxytocin (after umbilical cord clamping at 60 sec) is associated with significantly lower
mean intra-operative blood loss(blood loss in early oxytocin group was 640.00±240.90
compared to delayed oxytocin group was 793.06±306.35), higher postoperative
hemoglobin level(the reduction of hemoglobin level in early oxytocin group was -
0.72±0.33gm/dl compared to delayed oxytocin group was -1.29±0.41gm/dl), earlier
placental separation. On the other hand, delayed clamping of umbilical cord was
associated with significant neonatal hyperbilirubinemia with no any adverse effect on
neonatal Apgar score.
Conclusion: Early administration of oxytocin is advised to be performed in case of
delayed cord clamping during cesarean section as evidenced by lower intraoperative
blood loss, higher postoperative hemoglobin level , earlier placental separation.

اجريت هذه الدراسه وتهدف الى مقارنه النتائج الاموميه والوليديه بعد اعطاء الاكسيتوسين فى وقت مبكر( بعد ولادة الكتف )مقابل تاخر اعطاء الاكسيتوسين (بعد 60 ثانيه) فى حاله تاخر قطع الحبل السرى فى عمليه قيصريه اختياريه وتم من خلال هذه الدراسه تسجيل 124 امراه حامل وتم تقسيمها الى مجموعتين متساويتين , مجموعه اعطاء الاكسيتوسين المبكره(مع ولاده الكتف ) ومجموعة اعطاء الاكسيتوسين المتاخره(بعد 60 ثانيه ) , فى كلا المجموعتين قمنا باجراء قطع للحبل السرى عند 60 ثانيه و كشفت الدراسه عند وجود فروق ذات دلاله احصائيه بين المجموعتين حيث كان الاعطاء المبكر للاوكسيتوسين فى حالات تاخر قطع الحبل السرى له اثر ايجابى فى انخفاض فقدان الم اثناء العمليه وارتفاع مستوى الهيموجلوبين بعد اجراء العمليه وانفصال المشيمه مبكرا .

Issued also as CD

Text in English and abstract in Arabic & English.