Maternal Hemodynamics After Oxytocin Bolus

Compared With Infusion in the Third Stage of Labor:

A Randomized Controlled Trial
Gregory A. L. Davies, MD, Julie L. Tessier, MD, Mary C. Woodman, RN (EC),
Adrienne Lipson, MD, and Philip M. Hahn, MSc
OBJECTIVE: To assess the effects of oxytocin bolus or infusion on maternal hemodynamics in the third stage of labor.

necol 2005;105:294 9. 2005 by The American College of

Obstetricians and Gynecologists.)

METHODS: In a randomized, double-blind, double-dummy

fashion, 99 women received an intravenous oxytocin bolus
(10 IU push) and 102 women received an infusion (10 IU in
500 mL saline at 125 mL/h) at delivery of the anterior
shoulder. Mean arterial pressure and heart rate were measured every minute for 10 minutes, then every 5 minutes
for the next 20 minutes. These serial measurements were
analyzed using a 2-factor analysis of variance for repeated
measures.

LEVEL OF EVIDENCE: I

RESULTS: Serial mean arterial pressure measures varied

significantly between groups (interaction effect, P .002).
Mean arterial pressure ( standard deviation) nadirs were
reached after 10 minutes, 80.9 ( 11.0) mm Hg in the bolus
group compared with 77.0 ( 12.1) mm Hg in the dilute
infusion group. The mean difference (95% confidence interval) between groups was 4.0 (0.77.2) mm Hg. Serial
heart rate measures also varied between groups (interaction effect, P < .001). Mean heart rate ( standard deviation) peaked 1 minute after the oxytocin infusion, 115 (
27) beats per minute (bpm) in the bolus group compared
with 109 ( 21) bpm in the dilute infusion group. The
mean difference (95% confidence interval) between groups
was 6.6 bpm (0.1 to 13.3). The dilute oxytocin infusion
group experienced a greater mean estimated blood loss
(423.7 mL compared with 358.1 mL, P .029, t test),
increased use of additional oxytocics (35.3% compared with
22.2%, P .044, Fisher exact test) and a greater drop in
hemoglobin (admission minus postpartum) (17.4g/L compared with 11.4g/L, P .002, t test) compared with the
oxytocin bolus group.
CONCLUSION: Bolus oxytocin of 10 IU is not associated with
adverse hemodynamic responses and can safely be administered to women with intravenous access in the third stage of
labor for postpartum hemorrhage prophylaxis. (Obstet GyFrom the Division of Maternal-Fetal Medicine, Department of Obstetrics and
Gynecology, Queens University, Kingston, Ontario, Canada.
The authors thank Alistair MacLean, PhD,
Queens University, for his statistical advice.

294

C Psych,

Department of Psychology,

VOL. 105, NO. 2, FEBRUARY 2005

2005 by The American College of Obstetricians and Gynecologists.
Published by Lippincott Williams & Wilkins.

The use of prophylactic oxytocin in the third stage of

labor has been shown to decrease the incidence of postpartum hemorrhage by 50 60%.1 4 Obstetric texts advocate
the use of oxytocin, either intramuscularly or as a dilute
infusion, but warn against the use of intravenous bolus
oxytocin, fearing significant maternal hemodynamic consequences.5,6 Two commonly used obstetric references state
that intravenous oxytocin bolus is contraindicated and provide the following warnings: bolus injection of as little as
5 units may be associated with maternal hypotension,5
and oxytocin should never be given as an undiluted bolus
dose as serious hypotension or cardiac arrhythmias may
follow.6 These statements are either not referenced5 or use
case reports and small studies to justify the warning.6
Secher et al7 describe the hemodynamic response to oxytocin of 9 women undergoing termination of pregnancy in the
first trimester during general anesthesia. They found a 40%
decrease in femoral arterial pressure after a 10 IU bolus of
oxytocin, but no hemodynamic change when dilute oxytocin was infused.7 Hendricks and Brenner8 described a
woman, hypotensive from postpartum hemorrhage, who
received an intravenous bolus of 5 IU of oxytocin. The
authors relate a subsequent fall in blood pressure to the
oxytocin received. Understanding the hemodynamic effects of oxytocin is complicated by the heterogeneity of the
studied populations: men, nonpregnant women, and
women undergoing termination of pregnancy in the first
trimester.711 This study is designed to clarify the maternal
hemodynamic response to bolus oxytocin in the third stage
of labor.
MATERIALS AND METHODS
Women in active labor at Kingston General Hospital,
Kingston, Ontario, Canada, who were expected to de-

0029-7844/05/$30.00
doi:10.1097/01.AOG.0000148264.20909.bb

liver vaginally and who required an intravenous (epidural anesthesia, antibiotics, etc.) were approached for
participation in the study and informed consent was
obtained. The protocol was approved by the Queens
University Health Sciences Research Ethics Board.
Immediately after vaginal delivery of the neonate, and
before delivery of the placenta, participants received oxytocin either as a bolus or a dilute infusion in a double-blind,
double-dummy fashion. In this study design type each
group of subjects receives one of the active interventions
and a placebo (in this case called a dummy) that looks
the same as the other intervention. Such a design is
particularly useful when comparing interventions with
different modes of administration (such as bolus compared with continuous intravenous infusion).12
Randomization was performed by the study pharmacist using a computer-generated random numbers table.
The study pharmacist provided sealed, numbered packages containing 2 vials (1 containing 10 IU of oxytocin,
the other containing an equal volume of saline) that were
labeled as port for the bolus and bag for the infusion.
The oxytocin was not visually decipherable from saline.
The bolus oxytocin group received 10 IU of oxytocin as
an intravenous push (with an equal volume of saline
injected into 500 mL of normal saline and infused at 125
mL/h as the dummy). The oxytocin infusion group
received 10 IU of oxytocin in 500 mL of normal saline at
125 mL/h (with an equal volume of saline intravenous
push as the dummy). Blood pressure and heart rate were
measured on all participants using a single calibrated
automated sphygmomanometer (Critikon Inc., Tampa,
FL). A baseline (time 0) blood pressure and heart rate
were obtained between contractions just before delivery.
Immediately after the oxytocin was administered, maternal blood pressure and heart rate were measured every
minute for the first 10 minutes, then every 5 minutes for
the next 20 minutes, for a total of 30 minutes. Estimated
blood loss was recorded. Additional oxytocics (oxytocin,
ergot, prostaglandin F2) were available for excessive
postpartum bleeding, and the attending physician made
the diagnosis of postpartum hemorrhage.
Serial mean arterial pressure (MAP) and heart rate
measures were analyzed by a 2-factor repeated-measures
analysis of variance (ANOVA). The group factor had 2
levels (bolus compared with dilute infusion) and the time
factor had 15 levels (t0 to t30). The Huynh and Feldt
epsilon value was used to compensate for the absence of
sphericity by adjusting the associated degrees of freedom. Missing values were replaced by averaging the
closest before and after values within subjects. The use of
P values for baseline comparisons is considered inappropriate and do not appear in Tables 1 and 2.13,14 Chance
differences between the 2 groups were followed up with

VOL. 105, NO. 2, FEBRUARY 2005

Table 1. Baseline Characteristics of Participants by Treatment Group

Characteristic

Bolus
(n 99)

Infusion
(n 102)

Maternal age (y)

Gestational age (wk)
Gravidity
Admission hemoglobin (g/L)
Previous postpartum hemorrhage
Previous cesarean delivery

27.7 5.7
39.6 2.0
2.2 1.3
121.5 13.2
3 (3.0)
8 (8.1)

27.9 5.6
39.7 1.7
1.9 1.1
122.2 10.5
5 (4.9)
12 (11.8)

Values are mean standard deviation or number and (percentage).

appropriate adjusted or subgroup analyses. Continuous

outcomes (birth weight, length of third stage, estimated
blood loss, postpartum hemoglobin) were analyzed by t
tests. Changes in hemoglobin values were calculated by
subtracting postpartum values from admission values.
Categorical outcomes (third stage 30 minutes, retained placenta, additional oxytocics, estimated blood
loss 500 mL and 1,000 mL, blood transfusion,
postpartum hemoglobin 90 g/L) were analyzed by
Fisher exact tests. Statistical significance was set at P
0.05. Statistical computations were generated using SPSS
12.0 for Windows (SPSS Inc., Chicago, IL).
The sample size of 200 subjects was arbitrarily chosen.
Appropriate maternal hemodynamic estimates (MAP
and heart rate) and measures of dispersion (standard
deviations) were unavailable in previous reports. Available studies recruited subjects in the first trimester or
who were under general anesthesia, factors associated
with cardiovascular effects dramatically different from
the term and awake population we planned to study.710

Table 2. Intrapartum Characteristics of Participants and

Events by Treatment Group
Characteristic
Oxytocin induction or
augmentation
Magnesium sulfate
Antibiotics
Epidural anesthesia
Type of Delivery
Spontaneous vaginal delivery
Vacuum
Forceps
First stage of labor (min)
Second stage of labor (min)
Baseline mean arterial pressure
(mm Hg)
Baseline heart rate (beats per
minute)

Bolus
(n 99)

Infusion
(n 102)

62 (62.6)

77 (75.5)

5 (5.1)
22 (22.2)
82 (82.8)

5 (4.9)
30 (29.4)
87 (85.3)

73 (73.7)
69 (67.6)
16 (16.2)
18 (17.6)
10 (10.1)
15 (14.7)
519.1 251.6 484.8 274.9
84.8 68.2
87.9 73.6
91.6 13.2
90.4 10.2
97.4 22.9

99.8 21.1

Values are mean standard deviation or number and (percentage).

Davies et al

Oxytocin Hemodynamics

295

Fig. 1. Average maternal mean arterial pressure (MAP) (

standard error of the mean) after intravenous bolus or
dilute infusion of oxytocin. Time 0 refers to baseline
measurement during second stage of labor.

Fig. 2. Mean maternal heart rate ( standard error of the

mean) after intravenous bolus or dilute infusion of oxytocin.
Time 0 refers to baseline measurement during second
stage of labor. bpm, beats per minute.

Davies. Oxytocin Hemodynamics. Obstet Gynecol 2004.

Davies. Oxytocin Hemodynamics. Obstet Gynecol 2004.

RESULTS
Between January 1998 and August 1999, 201 women
were randomly assigned to receive oxytocin either as a
bolus (n 99) or dilute infusion (n 102). Baseline
characteristics of the participants by treatment group are
shown in Table 1, and intrapartum characteristics and
events are presented in Table 2. Two subjects from the
dilute infusion group with less than 4 of the 15 MAP or
HR measurements were excluded from the repeated
measures ANOVA. By chance, 12.9% more subjects
received oxytocin induction or augmentation in the dilute infusion group. As described below, this potential
confounder was further analyzed with adjusted and subgroup analyses.
Average MAP measures ( standard error of the
mean) after intravenous bolus or dilute infusion of oxytocin are shown in Figure 1. A significant time group
interaction (P .002) indicated that the serial MAP
measures varied between groups. Nadirs for MAP (
standard deviation) were reached after 10 minutes, 80.9
( 11.0) mm Hg in the bolus group compared with 77.0
( 12.1) mm Hg in the dilute infusion group. The mean
difference (95% confidence interval CI) after ten minutes between groups was 4.0 (0.77.2) mm Hg. Measures of MAP then rebounded and reached similar levels
at 30 minutes.
Mean heart rate measures ( standard error of the
mean) after intravenous bolus or dilute infusion of oxytocin are shown in Figure 2. A significant time x group
interaction (P .001) indicated that the serial HR measures varied between groups. Mean heart rate ( standard deviation) peaked 1 minute after the oxytocin infusion, 115 ( 27) beats per minute (bpm) in the bolus
group compared with 109 ( 21) bpm in the dilute
infusion group. The mean difference (95% CI) after 1

minute between groups was 6.6 bpm (0.1 to 13.3). On

average, heart rate returned to baseline within 4 minutes
in those receiving a dilute oxytocin infusion. Heart rate
for this group remained stable and then decreased marginally between 15 and 30 minutes. Similarly, heart rate
returned to baseline within 4 minutes in those receiving
a bolus oxytocin infusion. Thereafter, heart rate for this
group continued on a slight decline, stabilizing after 10
minutes and not fully rebounding by 30 minutes.
There were no patients in either group who experienced side effects associated with oxytocin infusion.
Continuous cardiac monitoring was not performed. No
woman complained of symptoms suggestive of, was
diagnosed with, or treated for an arrhythmia.
Postpartum outcomes by treatment group are shown
in Table 3. Birth weights were within the normal range,
and the mean difference between groups of 133.9 g was
not statistically significant. Length of the third stage and
rates of retained placenta were similar between the 2
groups. More subjects (13.1%) in the dilute infusion
group required additional oxytocics. Mean estimated
blood loss (95% CI) was greater by 65.6 mL (6.7124.6)
in the dilute infusion group. More subjects (9.1%) in the
dilute infusion group were estimated to have blood
losses 500 mL, and 1 more woman in this group had
an estimated blood loss of 1,000 mL. The mean
difference (95% CI) of 4.0 g/L (1.1 to 9.1) in postpartum hemoglobin was not statistically significant. The
decrease (95% CI) in hemoglobin from baseline was 6.0
g/L (2.39.7) greater in the infusion group. Two more
women in the dilute infusion group required a blood
transfusion. It can be estimated that for every 53 women
receiving a bolus oxytocin infusion compared with the
dilute infusion regimen, there would be 1 less blood
transfusion required.

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Table 3. Postpartum Outcomes by Treatment Group

Characteristic

Bolus
(n 99)

Dilute Infusion
(n 102)

Birth weight (g)

Third stage of labor (min)
Third stage of labor 30 min
Retained placenta
Additional oxytocics
Estimated blood loss (mL)
Estimated blood loss 500 mL
Estimated blood loss 1,000 mL
Blood transfusion
Postpartum hemoglobin (g/L)
Postpartum hemoglobin 90 g/L
Change in hemoglobin (g/L)

3,587.8 532.2
6.8 9.6
3 (3.0)
8 (8.1)
22 (22.2)
358.1 203.9
26 (28.0)
2 (2.2)
2 (2.0)
108.6 15.8
7 (9.1)
11.4 10.4

3,453.9 569.9
7.3 7.9
3 (2.9)
5 (4.9)
36 (35.3)
423.7 207.6
36 (37.1)
3 (3.1)
4 (3.9)
104.6 16.2
11 (14.1)
17.4 12.9

.087
.707
1.000
.403
.044
.029
.216
1.000
.683
.120
.453
.002

Values are mean standard deviation or number and (percentage). Data on estimated blood loss were missing for 6.1% of the bolus group and 4.9%
of the dilute infusion group. Data on postpartum hemoglobin were missing for 22.2% of the bolus group and 23.5% of the dilute infusion group.
Change in hemoglobin was calculated as admission hemoglobin minus postpartum hemoglobin before any transfusion. Means were analyzed by
t tests and rates by Fisher exact tests.

As stated above, by chance, 12.9% more subjects

received oxytocin induction or augmentation in the dilute infusion group (Table 2). To assess whether MAP
measures were associated with predelivery exposure
to oxytocin, we reanalyzed the repeated-measures
ANOVA adding a third factor (predelivery oxytocin
exposure) to the model. The time group interaction
remained statistically significant (P .001), reconfirming
serial MAP measures varied between groups (bolus compared with dilute infusion). The group predelivery
oxytocin exposure and time predelivery oxytocin
exposure interactions were not statistically significant
(P .553 and P .738, respectively). Therefore, adjusting for predelivery oxytocin exposure did not change the
interpretation for the MAP data.
To assess whether any outcomes listed in Table 3
were associated with predelivery exposure to oxytocin,
we conducted subgroup analyses (Tables 4 and 5). No
statistically significant differences were found. All but 1
subject with a postpartum hemoglobin less than 90 g/L
were exposed to predelivery oxytocin. In the bolus infusion group 11.6% more women exposed to predelivery

oxytocin had estimated blood losses of 500 mL or more.

A reduction in power related to stratifying the analyses
contributed to the possibility of false negatives (type II
errors).
DISCUSSION
Current obstetric teaching warns against the use of bolus
intravenous oxytocin for prophylaxis against postpartum hemorrhage as it may cause unexpected hypotension.5,6 Case reports and uncontrolled studies have been
used to justify this concern, but may not be generalizable
to a postpartum population not under general anesthesia.711 Weis et al9 studied 26 women having first trimester termination of pregnancy under general anesthetic
and noted a transient decrease in mean arterial pressure
and systemic vascular resistance, but an increase in
cardiac output with a 5 to 10 IU bolus of oxytocin.
Andersen et al10 noted similar findings in 22 women
given a 10 IU bolus of oxytocin at cesarean delivery.
Thirteen of these subjects received general anesthetic.
They noted less of an impact on MAP in women who

Table 4. Subgroup Analysis of Postpartum Outcomes by Predelivery Oxytocin Exposure for the Bolus Group
Outcome

Exposed
(n 62)

Not Exposed
(n 37)

Estimated blood loss (mL)

Estimated blood loss 500 mL
Blood transfusion
Admission hemoglobin (g/L)
Postpartum hemoglobin (g/L)
Postpartum hemoglobin 90 g/L
Change in hemoglobin (g/L)

368.6 222.8
19 (32.2)
2 (3.2)
119.6 14.4
107.7 17.8
7 (13.7)
11.0 10.4

339.7 167.8
7 (20.6)
0 (0)
124.7 10.3
110.4 11.2
0 (0)
12.2 10.6

.513
.337
.527
.041
.490
.088
.660

Values are mean standard deviation or number and (percentage). Data on estimated blood loss were missing for 6.1% of bolus group. Data on
postpartum hemoglobin were missing for 22.2% of bolus group. Change in hemoglobin was calculated as admission hemoglobin minus postpartum
hemoglobin prior to any transfusion. Means were analyzed by t tests and rates by Fisher exact tests.

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Table 5. Subgroup Analysis of Postpartum Outcomes by Predelivery Oxytocin Exposure for the Dilute Infusion Group
Outcome

Exposed
(n 77)

Not Exposed
(n 25)

Estimated blood loss (mL)

Estimated blood loss 500 mL
Blood transfusion
Admission hemoglobin (g/L)
Postpartum hemoglobin (g/L)
Postpartum hemoglobin 90 g/L
Change in hemoglobin (g/L)

424.0 209.0
27 (36.0)
3 (3.9)
121.6 11.0
103.2 16.9
10 (16.1)
18.4 13.6

422.7 207.4
9 (40.9)
1 (4.0)
124.0 8.8
109.9 12.7
1 (6.3)
13.8 8.8

.980
.429
1.000
.323
.143
.444
.204

Values are mean standard deviation or number and (percentage). Data on estimated blood loss were missing for 4.9% of the dilute infusion group.
Data on postpartum hemoglobin were missing for 23.5% of the dilute infusion group. Change in hemoglobin was calculated as admission
hemoglobin minus postpartum hemoglobin prior to any transfusion. Means were analyzed by t tests and rates by Fisher exact tests.

had an epidural or spinal anesthetic. In contrast, Sorbe15

described using a 10 IU bolus of oxytocin in 506 women
for postpartum hemorrhage prophylaxis. Although
blood pressure was not recorded, no patients described
symptoms or clinical signs of hypotension.
Previous studies of the human response to bolus oxytocin have primarily described men, nonpregnant
women, and women in the first trimester under general
anesthesia.711 In these small studies, bolus oxytocin of
10 IU has resulted in a fall in systemic vascular resistance
and MAP compensated by an increase in heart rate and
consequently cardiac output.7 This fall in MAP was less
in nonpregnant women placed in the lithotomy position,
presumably due to improved venous return.11 The different response experienced by our subjects may be due
to the 3-L increase in blood volume and 25% reduction
in systemic vascular resistance of late pregnancy. After
an oxytocin bolus an already low systemic vascular
resistance may not respond further or be more rapidly
compensated by the expanded blood volume. Autotransfusion associated with uterine contraction immediately
postpartum increases preload volumes maintaining
MAP. The difference in our findings compared with
those of Anderson et al10 may be explained by the fact
that most of our patients were in the lithotomy position,
and none received general anesthetic. The rise in heart
rate observed in the bolus group at 1 minute is consistent
with the findings of others and suggests that despite the
documented hemodynamic stability there may be some
minor and brief change in MAP before the 1-minute
assessment that is associated with a compensatory increase in HR.8 As demonstrated in Figure 2, heart rate in
the bolus group is less than that in the dilute infusion
group by minute 3.
Our study identified that women receiving bolus oxytocin for postpartum hemorrhage prophylaxis after vaginal delivery had a higher MAP than those who received
a dilute oxytocin infusion. Women receiving bolus oxytocin also experienced less blood loss, less postpartum
hemorrhage, and less change in hemoglobin levels. We

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Oxytocin Hemodynamics

recognize that estimates of blood loss are frequently

inaccurate and notoriously underestimated by physicians.16 However, given the double-blinded nature of
our protocol, there is no reason to believe that a bias
exists in reporting blood loss in one group compared
with another.
The estimates of blood loss and change in hemoglobin
were significantly greater in the infusion group. These
findings are likely related to the fact that women in the
infusion group were exposed to very little oxytocin
during the 30 minutes of observation. An infusion containing 10 IU of oxytocin in 500 mL of saline infusing at
125 mL/h would deliver only 1.25 IU of oxytocin to the
uterus in 30 minutes. Blood loss may have been less had
a faster infusion of dilute oxytocin been used. Bolus
oxytocin of 10 IU can safely be given to women with
intravenous access in the third stage of labor for postpartum hemorrhage prophylaxis.

REFERENCES
1. Prendiville WJ, Elbourne D, Chalmers I. The effects of
routine oxytocic administration in the management of the
third stage of labour: an overview of the evidence from
controlled trials. Br J Obstet Gynaecol 1988;95:316.
2. Prendiville WJ, Harsing JE, Elbourne DR, Stirrat GM.
The Bristol third stage trial: active versus physiological
management of the third stage of labour. BMJ 1988;297:
1295301.
3. Elbourne DR, Prendiville WJ, Carroli G, Wood J,
McDonald S. Prophylactic use of oxytocin in the third
stage of labour (Cochrane Review). In: The Cochrane
Library, Issue 2, 2004. Chichester: John Wiley & Sons,
Ltd.
4. Prendiville WJ, Elbourne D, McDonald S. Active versus
expectant management in the third stage of labour
(Cochrane Review). In: The Cochrane Library, Issue 2,
2004. Chichester: John Wiley & Sons, Ltd.
5. Benedetti TJ. Obstetric hemorrhage. In: Gabbe SG, Niebyl
JR, Simpson JL, editors. Obstetrics: normal and problem

OBSTETRICS & GYNECOLOGY

6.

7.

8.

9.
10.

11.

pregnancies. 3rd ed. New York (NY): Churchill Livingstone; 1996. p. 499 532.
Obstetrical hemorrhage. In: Cunningham FG, MacDonald PC, Gant NF, Leveno KJ, Gilstrap LC, Hankins
GDV, Clark SL, editors. Williams obstetrics. 20th ed.
Stamford (CT): Appleton & Lange; 1997. p. 745782.
Secher NJ, Arnsbo P, Wallin L. Haemodynamic effects of
oxytocin (syntocinon) and methyl ergometrine (methergin) on the systemic and pulmonary circulations of pregnant anaesthetized women. Acta Obstet Gynecol Scand
1978;57:97103.
Hendricks CH, Brenner WE. Cardiovascular effects of
oxytocic drugs used postpartum. Am J Obstet Gynecol
1970;108:751 60.
Weis FR Jr. , Markello R, Mo B, Bochiechio P. Cardiovascular effects of oxytocin. Obstet Gynecol 1975;46:211 4.
Andersen TW, DePadua CB, Strenger V, Prystowsky H.
Cardiovascular effects of rapid intravenous injection of
synthetic oxytocin during elective cesarean section. Clin
Pharmacol Ther 1965;6:3459.
Johnstone M. The cardiovascular effects of oxytocic drugs.
Br J Anaesth 1972;44:826 34.

VOL. 105, NO. 2, FEBRUARY 2005

12. Jadad AR. Randomised controlled trials: a users guide.

London: BMJ Books; 1998. p. 22.
13. Altman DG. Practical statistics for medical research. New
York (NY): Chapman & Hall; 1991. p. 396 419.
14. Cummings P. Reporting statistical information in medical
journals. Arch Pediatr Adolesc Med 2003;157:321 4.
15. Sorbe B. Active pharmacologic management of the third
stage of labor: a comparison of oxytocin and ergometrine.
Obstet Gynecol 1978;52:694 7.
16. Brucker MC. Management of the third stage of labor: an
evidence-based approach. J Midwifery Womens Health
2001;46:38192.

Address reprint requests to: Dr. G. A. L. Davies, Victory 4,

Kingston General Hospital, Kingston, Ontario, Canada K7L
2V7; e-mail: gd7@post.queensu.ca.

Received May 14, 2004. Received in revised form September 20, 2004.
Accepted September 23, 2004.

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