Avoidance of uterotonics

The IS-AIP evidence based guideline states:

"Prophylactic administration of oxytocin immediately after delivery increases contraction of the uterus which could be helpful for the assessment of placental separation. If the whole placental bed is abnormally invasive, uterine contraction will not result in any placental separation. If, however, the placenta is only partially adherent or invasive, uterine contraction may cause some separation leading to increased blood loss which could prompt the surgeon to either forcibly remove the rest of the placenta or perform a more hurried hysterectomy. In light of this risk, the IS-AIP recommend that when AIP is suspected antenatally, prophylactic uterotonic agents should not be routinely given immediately after delivery of the infant. Instead a full assessment should be made in accordance with the intraoperative diagnosis recommendations (see next topic). Only if the placenta is removed, either fully or partially, or there is already significant bleeding, should uterotonics be given (Grade D recommendation)."

The SAC technique follows these guidelines and do not administer uterotonics following delivery of baby in cases of suspected PAS.