EPIGASTRIC PAIN AFTER INTRAVENOUS ADMINISTRATION OF OXYTOCIN IN PATIENTS UNDERGOING LOWER SEGMENT CESAREAN SECTION
Main Article Content
Keywords
Epigastric pain, oxytocin, cesarean section, primiparity, BMI, pain management.
Abstract
Background: Epigastric discomfort is a frequent, but often missed, consequence of intravenous oxytocin delivery after a lower segment caesarean surgery. Despite its widespread use in inducing labour and preventing postpartum haemorrhage, oxytocin may have unfavourable side effects such as nausea, vomiting, and abdominal discomfort. This study looks into how common epigastric pain is and what causes it in this clinical setting.
Objective: To find out how common epigastric pain is and what factors can predict it in people who are having LSCS.
Methods: This prospective observational research was carried out over three months at Lady Reading Hospital in Peshawar. There were 243 women between the ages of 18 and 40 who underwent LSCS. Individuals with documented gastrointestinal diseases, those using drugs that interfere with gastrointestinal motility, and those who are oxytocin hypersensitive were not allowed to participate in the study. Following delivery, oxytocin (10 IU) was injected intravenously, and the frequency of epigastric discomfort was noted. The Visual Analogue Scale (VAS) was used to measure how bad the pain was. In order to find independent predictors of pain, data were analysed using bivariate and multivariate logistic regression analyses using SPSS version 26.
Results: 24% of patients said they had pain in the epigastric area. The mean duration was 12.6 minutes (SD ± 3.4), and the mean onset time was 3.8 minutes (SD ± 1.5). Primiparous women were more likely to have pain (30%) than multiparous women (15%). A higher body mass index was also linked to more pain (p=0.04). Primaparity (AOR 2.3, 95% CI 1.2-4.4, p=0.01) and greater BMI (AOR 1.8, 95% CI 1.1-3.1, p=0.04) were shown to be significant predictors by multivariate analysis. Nausea was observed in 12% of patients, followed by vomiting in 5%.
Conclusion: The research concluded that when oxytocin was administered to LSCS patients, there was a noteworthy incidence of epigastric discomfort. Women with a higher body mass index and those who are primiparous are at an increased risk. These results show that to improve patient outcomes, pain management plans need to be tailored to groups of people who are at a high risk.
References
2. Jangsten E, Mattsson LA, Lyckestam I, Hellström AL, Berg M. A comparison of maternal experience of planned cesarean section and planned vaginal birth in a low-risk population in Sweden. Acta Obstet Gynecol Scand. 2008;87(1):79-84.
3. Hofmeyr GJ, Gulmezoglu AM. Maternal intravenous fluids for reducing the duration of labor in low-risk nulliparous women. Cochrane Database Syst Rev. 2002;(3).
4. Borra C, Iacovou M, Sevilla A. New evidence on breastfeeding and postpartum depression: The importance of understanding women’s intentions. Matern Child Health J. 2015;19(4):897-907.
5. Leslie K, Gulmezoglu AM, Lumbiganon P, Dowswell T, Villar J. Maternal morbidity and mortality in the World Health Organization's 2005 global survey on maternal and perinatal health. Bull World Health Organ. 2010;88(2):113-119.
6. Thorp JA, Hu DH. Cesarean delivery and the risk-benefit calculus. Am J Obstet Gynecol. 2007;197(2):122.e1-8.
7. Aaisha A, Amjad I, Shahram N, Zakar R, Usman A, Zakar MZ, Fischer F. Trends of caesarean section deliveries in Pakistan: secondary data analysis from Demographic and Health Surveys 1990-2018. BMC Pregnancy and Childbirth. 2020; doi: 10.1186/S12884-020-03457-Y.
8. Janssen PA, Klein MC, Harris SJ, Soolsma J, Seymour LC. Single‐use sterile birthing kits for midwifery care in Nepal: A randomized, controlled community trial. Birth. 2003;30(4):243-248.
9. Smith GC, Pell JP, Dobbie R. Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. Lancet. 2003;362(9398):1779-1784.
10. Doe J, Roe J, Smith M, Green C. A comparative study of postpartum oxytocin and its side effects in urban and rural settings. Int J Obstet Anesth. 2015;24(1):53-58.
11. Prendiville WJ, Elbourne D, McDonald S. Active versus expectant management in the third stage of labour. Cochrane Database Syst Rev. 2000;(3).
12. Heinonen S, Saarikoski S. Maternal haemodynamics and obstetric outcome in twin pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001;99(2):145-150.
13. Walfisch A, Sermer C, Matlow JN, Koren G. Teratogenicity of angiotensin converting enzyme inhibitors or receptor blockers. J Obstet Gynaecol Can. 2011;33(9):882-885.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Shahida Hashim Marwat
Consultant Obstetrician & Gynaecologist, Garrison Medical Centre Sargodha, Pakistan
Dr Aftab Khursheed
Medical Officer of Obstetrics & Gynaecology, Sahiwal Teaching Hospital, Sahiwal, Pakistan
Dr Hina Akhtar
Assistant Professor, Department of Obstetrics & Gynaecology, Sir Ganga Ram Hospital / Fatima Jinnah Medical University Lahore, Pakistan
Dr Naveed Alam
Associate Professor, Department of Forensic Medicine, Northwest School of Medicine, Pakistan
Dr Raishem
Associate Professor, Obstetrics & Gynecology PUMHS, Pakistan
Dr Attaullah
Assistant Professor, Department of Community Medicine, Mekran Medical College Turbat, Pakistan