The Effect of the Combined Use of methylergometrine and oxytocin during cesarean section in the prevention of post-partum haemorrhage

AbstractObjectivePostpartum hemorrhage (PPH) is an important contributory factor to maternal morbidity and mortality worldwide, and there is no consensus on treatment method or the superiority of one therapeutic approach over another.This study aimed to assess the efficacy of oxytocin compared with the combined administration of oxytocin and methylergometrine in preventing postpartum hemorrhage in cesarean sections. MethodologyThis study was conducted retrospectively on 1292 female patients aged 18-35 at the xxxxx Research and Training Hospital from January to December 2022. Participants were categorized into two groups: one receiving oxytocin alone and the other receiving a combination of oxytocin and methylergometrine The primary outcome measures included postpartum hemorrhage (PPH), assessed by changes in hemoglobin and hematocrit levels, in along with intraoperative blood loss. Secondary outcomes included the use of supplemental intraoperative hemostatic uterine sutures, the length of the surgical process, the need for further uterotonics, and the demand for blood transfusion. Results There were significant differences in the need for additional uterotonics 27.2(182) %,13.9% (87) p= 0.005, the change in pre-and postoperative hemoglobin concentration 10.81±0.93, 8.23±1.11, p= 0.001 and hematocrit 11.89±0.93, 10.31±1.20, p= 0.001 There were no significant differences between the groups in terms of operating time, blood transfusion requirements, or need for additional hemostatic sutures.Conclusions: The combination of oxytocin and methylergometrine effectively reduced postpartum bleeding in women undergoing cesarean sections. This group required less uterotonic treatment, had smaller declines in hemoglobin and hematocrit levels, and experienced less blood loss during cesarean section..