The effect of oxytocin dose on the ST segment change, arterial hypotension and blood loss in women of different age groups during cesarean section

E.N. Degtyarev1, E.M. Shifman2, G.P. Tikhova3, A.V.Kulikov4

1 Amur Regional Clinical Hospital, Perinatal Center, Blagoveschensk

2 M.F. Vladimirskiy Moscow Regional Research Clinical Institute, Moscow

3 Petrozavodsk State University, Petrozavodsk

4 Federal State Budgetary Educational Institution of Higher Education “Urals State Medical University” of the Ministry of Healthcare of the Russian Federation, Ekatertinburg

For correspondence: Evgeny N. Degtyarev — physician of the Department of anesthesiology and intensive care at maternity obstetric service, Amur Regional Clinical Hospital, Perinatal Center, Blagoveschensk; e-mail: dormicumtrade@gmail.com

For citation: Degtyarev EN, Shifman EM, Tikhova GP, Kulikov AV. The effect of oxytocin dose on the ST segment change, arterial hypotension and blood loss in women of different age groups during cesarean section. Alexander Saltanov Intensive Care Herald. 2018;3:77–86.

DOI: 10.21320/1818-474X-2018-3-77-86


Oxytocin (OT) is a first-line drug in the prevention and treatment of postpartum hemorrhages. There are a number of studies showing that with prolonged infusion of OT, the concentration of the marker of myocardial damage of troponin and the depression of the ST segment on the ECG increase. As before, the question of hemodynamic effects and the effect on the myocardium of various doses of oxytocin, the concentrations of intravenous microfluidine administration in various categories of parturient women, remains unresolved.

Objective. To conduct a comparative study of the effect of oxytocin dose on ST segment depression, during the operation, cesarean section under spinal anesthesia in somatically healthy primaparous young and optimal reproductive age.

Materials and methods of research. A prospective, randomized study of ST-segment depression after administration of oxytocin was performed in 44 primaparous patients aged 15 to 25 years. Operative delivery was performed routinely under spinal anesthesia using a standard procedure. The conclusion about ST segment depression was made when the segment was located below the isoelectric 0.5 mm. All patients were randomized into 2 groups according to the dose of OT recommended by different clinical recommendations 5 and 10 units.

Results. In our study, the risk of developing acute depression of the ST segment directly depended on the dose of injected uterotonics. Thus, in the group of patients who received RT at a dose of 10 U, the risk of developing depression of the ST segment was 8.6 times higher than in the group where the dose of OT was 5 units. Among young primaparas, the risk of developing depression of the ST segment is 9 times higher with the administration of OT in a dose of 10 units.

Conclusion. Depression of the ST segment (more than 0.5 mm) directly depends on the dose of oxytocin administered during the operation by cesarean section.

Keywords: oxytocin, young primapara, cesarean section

Received: 23.07.2018


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