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Oxytocin Dose Caesarean Section — FRCA Final MCQ

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ModerateObstetric AnaesthesiaOxytocin Dose Caesarean SectionFRCA Final

A 38-year-old woman (ASA II, 72 kg) has an uncomplicated emergency caesarean section under spinal anaesthesia. The surgeon has closed the uterus and asks for oxytocin. According to the RCOG and OAA, what is the recommended initial dose and route of oxytocin after caesarean delivery?

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Correct answer: D — 5 IU slow IV injection (over 1-2 minutes)

The OAA and RCOG recommend oxytocin 5 IU by slow IV injection (over 1-2 minutes) after caesarean delivery. Rapid IV bolus of oxytocin causes significant haemodynamic effects: hypotension (due to vasodilation), tachycardia, flushing, and chest pain. These effects are dose-dependent and exaggerated by rapid administration. 10 IU boluses are associated with worse haemodynamic instability. If additional uterotonic therapy is needed, an oxytocin infusion (40 IU in 500 mL at 125 mL/hr) is commenced.

Reference: RCOG – 2016 – GTG 52 PPH prevention; OAA – 2024 – QRH: Oxytocin administration