Article Text
Abstract
Objectives Oxytocin is used to augment labour in approximately one sixth of cases. We wanted to examine whether a delay in Oxytocin administration causes a change in mode of delivery, overall blood loss or outcome for the baby.
Method We performed a retrospective study of the Princess Anne Hospital, Southampton birth database between July 2011 and June 2013, examining cases in which Oxytocin had been used for augmentation of labour.
Results A total of 1260 cases of singleton pregnancies in which labour was augmented were reviewed. In 1014 (80.4%) cases, Oxytocin was administered within one hour of the decision time. Delay of more than one hour in administration was usually secondary to a holdup in siting an epidural or an inability to provide one to one care (74.2%); in a small proportion of cases, maternal request was a factor (9.7%).
Women who had the start of their Oxytocin infusion postponed for more than one hour were more likely to require an emergency Caesarean section (37.8%) than those who did not (30.2%) (p = 0.0211). No statistical difference was seen in the maternal blood loss or APGAR scores. The same was true when groups were subdivided into primigravida and multiparous women.
Conclusions The increased risk of Caesarean section in women, when there is a delay in commencement of Oxytocin infusion for augmentation highlights the importance of prompt action and active management of labour in these women.