Granisetron prophylaxis does not affect myometrial contraction during caesarean birth

When administered concomitantly with oxytocin, prophylactic granisetron appears to have no negative impact on myometrial contraction during caesarean delivery, reports a recent study.

A team of researchers conducted a prospective randomized controlled trial of 60 women, half of whom were given 3-mg granisetron while the other half received a 3-mL saline control. Both interventions were given 5 minutes before the spinal block. All patients were undergoing elective caesarean delivery and concomitantly received a 10 U infusion of oxytocin.

Outcomes included subjective uterine tone, assessed as adequate or not by a blinded obstetrician using manual palpitation, as well as estimated blood loss, the need for additional uterotonic agents, haematocrit, and neonatal Apgar scores.

After the procedure, the obstetrician reported no significant difference in uterine tone between treatment arms. At 3 minutes, for instance, 73.3 percent of the granisetron group were deemed to have adequate uterine tone, as compared with 66.7 percent of saline comparators (p=0.573).

Respective adequacy rates at 6, 9, and 12 minutes were 80 percent and 73.3 percent (p=0.542), 83.3 percent and 86.7 percent (p=0.718), and 100 percent and 100 percent (p=1.0).

In addition, estimated blood loss, the need for additional uterotonic agents, and change values in haematocrit after the procedure did not differ between treatment groups.

“The use of prophylactically granisetron during caesarean delivery does not seem to affect myometrial contraction when concomitant oxytocin is administered. Therefore, granisetron can be used safely in parturients undergoing caesarean delivery,” the researchers said.