The use of oxytocin for induction and augmentation of labour is a major component in the active management of labour. Its use is associated with lower caesarean section rates however it carries potential for uterine hyperstimulation/tachysystole and fetal compromise.
We sought to compare the standard ‘high-dose’ regimen employed in the Rotunda hospital until July2010 with a lower dose regimen.
The regimen of oxytocin for induction/augmentation of primigravid labour changed on 1/07/2010 to a ‘low-dose’ regimen commonly employed internationally. We prospectively recorded maternal characteristics and perinatal outcomes among primiparous women exposed to the'low-dose' regimen (September2010) and those exposed to the high-dose regimen in June2010.
116 primiparous women received the high-dose oxytocin regimen. 143 women received the low-dose regimen. Maternal characteristics (maternal age, gestation or induced labour rates) were similar in the two cohorts. There was no significant difference in duration of the 1st stage of labour. A decreased incidence of uterine hyperstimulation was observed in women exposed to the low-dose regimen (8.4vs46.6%, p<0.0001). The low-dose regimen was also associated with a statistically significant reduction in the duration of the second stage of labour. Although a trend was observed toward an increased caesarean delivery rate with the lower dose regimen, this did not achieve statistical significance (20.3vs16.4%, p=0.4218). Rates of NICU admission, instrumental delivery or anal sphincter injury were similar in both groups.
Our findings suggest a low-dose oxytocin regimen is associated with decreased uterine hyperstimulation and decreased duration of the second stage of labour. Mode of delivery and perinatal outcome were unaffected.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.