Oxytocin Intravena Vs Intramuskular sebagai Profilaksis Perdarahan Postpartum

Oleh :

dr. Audiza Luthffia

Pemberian oxytocin yang optimal sebagai profilaksis perdarahan postpartum, apakah intravena atau intramuskular, hingga saat ini belum ada rekomendasi yang jelas. Beberapa studi telah mencoba membandingkan efikasi dan keamanan pemberian oxytocin secara intravena dan intramuskular untuk mencegah perdarahan postpartum.

Oxytocin merupakan agen uterotonik yang paling direkomendasikan dan paling sering digunakan dalam praktik sehari-hari. Selain karena oxytocin tersedia dengan luas, efek uterotoniknya juga baik dan efek sampingnya lebih sedikit daripada agen uterotonik lain. Pemberian oxytocin baik secara intravena maupun intramuskular telah terbukti efektif untuk mengurangi volume perdarahan postpartum.[1-4]

Sekilas Tentang Oxytocin sebagai Profilaksis Perdarahan Postpartum

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. World Health Organization. WHO recommendations: Uterotonics for the prevention of postpartum haemorrhage. 2018. https://apps.who.int/iris/bitstream/handle/10665/277276/9789241550420-eng.pdf?ua=1
2. Salati JA, Leathersich SJ, et al. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database of Systematic Reviews 2019, Issue 4.
3. ladapo OT, Okusanya BO, et al. Intravenous versus intramuscular prophylactic oxytocin for reducing blood loss in the third stage of labour. Cochrane Database of Systematic Reviews 2020, Issue 11. Art. No.: CD009332.
4. Charles D, Anger H, Dabash R, Darwish E, Ramadan MC, Mansy A, Salem Y, Dzuba IG, Byrne ME, Breebaart M, Winikoff B. Intramuscular injection, intravenous infusion, and intravenous bolus of oxytocin in the third stage of labor for prevention of postpartum hemorrhage: a three-arm randomized control trial. BMC Pregnancy Childbirth. 2019; 19(1): 38.
5. Adnan N, Boland F, Murphy DJ. Intramuscular oxytocin versus intravenous oxytocin to prevent postpartum haemorrhage at vaginal delivery (LabOR trial): study protocol for a randomised controlled trial. Trials. 2017 ;18(1):541.
6. Wu Y, Wang H, et al. A meta-analysis of the effects of intramuscular and intravenous injection of oxytocin on the third stage of labor. Arch Gynecol Obstet. 2020; 301(3):643-653.
7. Royal College of Obstetricians and Gynaecologists. Prevention and management of postpartum haemorrhage (green-top guideline No. 52). BJOG. 2016; 124:e106–e149.
8. American College of Obstetricians and Gynecologists. Practice Bulletin No. 183: postpartum hemorrhage. Obstet Gynecol. 2017; 130:e168–e186.
9. Zhou YH, Xie Y, et al. Intramuscular versus intravenous oxytocin for the third stage of labor after vaginal delivery to prevent postpartum hemorrhage: a meta-analysis of randomized controlled trials. Eur J Obstet Gynecol Reprod Biol. 2020; 250:265-271.
10. Okaforcha EI, Eleje GU, et al. Intravenous versus intramuscular oxytocin injection for preventing uterine atonic primary postpartum haemorrhage in third stage of labour: A double-blind randomised controlled trial. SAGE Open Medicine. 2024;12.
11. Ai W, Zeng Y, et al. Side-effects of intravenously versus intramuscularly oxytocin for postpartum hemorrhage: a systematic review and meta-analysis of randomized controlled trials. Front Pharmacol. 2023 Dec 22;14:1273771.