Postpartum Hemorrhage Clinical Trial
Official title:
In-vitro Myometrial Contractility After Oxytocin Pre-exposure in Women With Advanced Maternal Age and Morbid Obesity
Women with advanced maternal age and morbid obesity, have a higher incidence of labor
induction/ augmentation and cesarean section (CS), and are at a greater risk for postpartum
hemorrhage (PPH). Oxytocin is the first line drug in the treatment of PPH, however, oxytocin
receptor (OTR) desensitization has been recognized in the context of prolonged labors
secondary to either endogenous or exogenous oxytocin exposure. It is unknown if oxytocin
desensitization specifically affects contractility in women with advanced maternal age and
morbid obesity when compared to younger or normal weight populations. Further it is not known
if the higher incidence of PPH seen in these women is due to poor uterine contractility
and/or poor response to oxytocin.
The investigators hypothesize that women with advanced maternal age and morbid obesity will
exhibit poor myometrial contractility as compared to women that are younger and of normal
body habitus, in both oxytocin pre-treated and untreated myometrium.
In view of the growing concern over the rising incidence of later maternal age and morbid obesity in the obstetric population, scientific evidence on pregnancy outcomes in these patients is timely and important. The investigators' previously validated in-vitro model provides a solid foundation for the study of myometrial contractility under controlled conditions, without any confounders that could be encountered in clinical settings. It is also likely to provide in-depth understanding of the parameters that the investigators feel are responsible for higher incidence of PPH in these patients. The investigators' study will form a basis for future modifications in oxytocin augmentation regimens and pharmacotherapy for control of PPH in these patient populations. ;
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