Situations in Which Oxytocin Was Administrated by Paramedics in Out-of-Hospital Births: A Retrospective Analysis over Six Years in the Polish Population

Abstract

Introduction: Postpartum haemorrhage (PPH) is a leading cause of maternal mortality worldwide, particularly in low- and middle-income countries, complicating 1% to 10% of deliveries. Despite improvement in prevention and management, variations in PPH definitions and measurement methods contribute to challenges in accurately assessing its incidence, with up to 90% of PPH-related deaths in high-income countries deemed avoidable through timely intervention. Oxytocin is the primary drug administered during labour or miscarriage, causing an increase in uterine muscle tone, which reduces bleeding and the risk of complications. The aim of the study was to assess the rate of oxytocin use by paramedics for out-of-hospital births in Poland and to verify adherence to WHO-recommended protocols for preventing postpartum haemorrhage in emergency prehospital settings. Methods: We conducted a cross-sectional study using data from the Polish Central System for Emergency Medical Services Missions Monitoring covering all EMS interventions nationwide from 2018 to 2023. The study included cases where oxytocin was administered during EMS interventions for pregnant women, identified through ICD-10 codes (O30-O92), with 62 verified cases meeting the inclusion criteria. Results: Over 6 years, oxytocin was administered in 62 cases when paramedics responded to emergencies involving pregnant women. The mean age of the patients to whom the oxytocin was administered was 29.48 years (SD = 6.25) and ranged from 15 to 43 years. Conclusions: Oxytocin is rarely administered by EMS teams at the prehospital stage. Oxytocin should be considered for incorporation into the set of medications that EMS teams can administer in prehospital settings. There is a need to train EMS teams in the management of pregnancy-related emergencies in accordance with the current medical guidelines.

Keywords: EMS; ambulance; birth; oxytocin; paramedic; postpartum haemorrhage.

Figure 1

Exclusion and inclusion criteria for the study. ICD 10—International Classification of Diseases, 10th Revision; *—means any character.