Background: Oxytocin is the first-line uterotonic for the prevention of postpartum hemorrhage (PPH), yet the optimal dosage remains uncertain. We conducted a systemic review to assess the preventive effects of high- and low-dose oxytocin on PPH and its impact on clinical outcomes. Methods: Randomized controlled trials (RCTs) comparing high- versus low-dose oxytocin for PPH prevention were systematically searched in PubMed, China National Knowledge Infrastructure (CNKI), Embase, Web of Science, the Cochrane Library, Ovid Technologies (OVID), and Wanfang databases up to April 2025. The data were pooled using Review Manager (RevMan), version 5.3. The primary outcome was the incidence of PPH, and secondary outcomes included adverse outcomes. Results: 6 RCTs involving 3615 women (1705 receiving high-dose oxytocin; 1910 receiving low-dose oxytocin) were included. High-dose oxytocin significantly reduced the incidence of PPH compared with the low-dose regimens (odds ratio OR = 0.44, 95% confidence interval CI: 0.32–0.62, p 0.05). Conclusions: High-dose oxytocin is more effective than low-dose regimens in preventing PPH without increasing adverse events, supporting dose optimization in clinical protocols.
Qu et al. (Fri,) studied this question.