Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Objective: To evaluate the effect of oxytocin in reducing intraoperative blood loss in patients with PAS disorders planned for cesarean hysterectomy. Methods: A total of 84 women with PAS disorders planned for cesarean hysterectomy were enrolled prospectively, all of those patients presented during the interval from February 2019 to August 2020 to the Department of Obstetrics and Gynecology, Cairo University. Informed consent was obtained from all patients, they were subjected to history taking, full physical examination and ultrasound diagnosis of PAS was made, the patients (84) were equally randomized into two groups, Group (A): 42 patients (the oxytocin group) and Group (B): 42 patients (the no-oxytocin group). After fetal delivery, an IV infusion containing 20 units of oxytocin per liter of crystalloid is infused at 10 ml/min in the oxytocin group.. In both groups, patients{u2019} demographics, intraoperative blood loss, vaginal bleeding, need for blood transfusion, pre and postoperative hemoglobin and hematocrit values, operative time, any injuries and ICU admission were recorded and analyzed Results: The estimated mean intraoperative blood loss and mean vaginal bleeding were found to be significantly more in the no-oxytocin (2989.29 ml and 234.84 ml respectively) versus the oxytocin (2117.86 ml and 121.43 ml respectively) groups (P value 0.001). The mean number of PRCs units transfused were significantly lower in the oxytocin group (2.64 units) compared to the no-oxytocin group (4.43 units) (P value 0.001). The incidence of bladder injury was significantly higher in the no-oxytocin (33.3%) group compared to the oxytocin group (14.3%). There was no significant difference between both groups regarding the pre and postoperative hemoglobin and hematocrit levels, operative time or incidence of ICU admission

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