A randomized controlled, open-label, non-inferiority trial to compare the efficacy and safety of low-dose oxytocin versus standard-dose oxytocin in achieving adequate uterine tone and preventing postpartum haemorrhage during scheduled cesarean deliveries

Postpartum haemorrhage (PPH) is a leading cause of maternal morbidity and mortality,

particularly after cesarean deliveries. Oxytocin is the first-line uterotonic recommended

globally to prevent uterine atony and PPH. Historically, high prophylactic doses were used,

but newer evidence suggests that lower doses may be equally effective with fewer adverse

effects. Guidelines such as ERAS 2025 promote individualized, lower-dose regimens to

minimize side effects like hypotension and tachycardia. However, there is variability in

practice, and optimal dosing in low-risk scheduled cesareans remains unclear, especially in

Indian settings, necessitating further evaluation through randomized clinical trial

This study will provide robust evidence on whether a low-dose oxytocin regimen is non-

inferior to the standard dose in achieving adequate uterine tone during scheduled cesarean

deliveries. It will also assess the impact on intraoperative blood loss, requirement for

additional uterotonics, and maternal hemodynamic stability. By directly comparing both

regimens under a randomized, controlled, real-world clinical setting, the findings will help

refine oxytocin dosing protocols. The study’s outcomes could support adoption of lower

prophylactic doses, improving safety profiles while maintaining efficacy, and may

contribute to national and international guideline updates for PPH prevention in cesarean

deliveries.