PL.88 Syntocinon Infusion: A Prospective Audit at St John’s Hospital (Nov 2010 – April 2011)
Introduction The use of oxytocin infusion in the induction and augmentation of labour is an essential component of intra-partum care in obstetrics worldwide but can be associated with potentially serious complications. These complications include uterine hyperstimulation leading to abnormalities in the CTG, uterine rupture especially in labouring women with previous uterine scar, fluid overload and postpartum haemorrhage (prolonged usage). In the light of these potentially serious but avoidable complications, it is imperative to use it judiciously in accordance with clinical guidelines.
The Aim of this audit was to determine the adherence of the unit to the designated clinical guideline in the use of syntocinon infusion in labour and to ascertain and analyse the underlying reasons for the complete stoppage of infusion and the reduction in the dosage of infusions.
Results and Discussions Majority of patients on syntocinon infusion carried on to delivery without having syntocinon stopped (99.08%) or reduced (66.9%). A significant number though still had syntocinon reduced at least on 1 occasion (33.1%).
The commonest reason for reducing rate of infusion was hyperstimulations (42/51), followed by other reasons such maternal distress, stopping to site epidural and “tissued venflon” representing (12/51) and prolonged and persistent decelerations.
Conclusions The use of syntocinon infusion to augment or induce labour at St John’s Hospital conforms to the established Pan-lothian guideline.
It is acceptable practise to reduce the rate of infusion when there is uterine hyperstimulation and to stop the infusion completely in the event of prolonged bradycardia and pathological CTG (NICE guideline).