High-dose oxytocin augmentation of labor safe and effective

January 01, 0001

High-dose oxytocin augmentation of labor safe and effective

These investigators examined the effects and safety of high- dose (compared with low-dose) oxytocin regimen for labor augmentation on perinatal outcomes. Data from the Consortium on Safe Labor were used. A total of 15,054 women from six hospitals were eligible for the analysis. Women were grouped based on their oxytocin starting dose and incremental dosing of 1, 2, and 4 milliunits/min. Duration of labor and a number of maternal and neonatal outcomes were compared among these three groups stratified by parity. Multivariable logistic regression and generalized linear mixed model were used to adjust for potential confounders.

They found: "Oxytocin regimen did not affect the rate of cesarean delivery or other perinatal outcomes. Compared with 1 milliunit/min, the regimens starting with 2 milliunits/min and 4 milliunits/min reduced the duration of first stage by 0.8 hours and 1.3 hours, respectively, in nulliparous women. No effect was observed on the second stage of labor. Similar patterns were observed in multiparous women. High-dose regimen was associated with a reduced risk of meconium stain, chorioamnionitis, and newborn fever in multiparous women."

The authors concluded: "High-dose oxytocin regimen (starting dose at 4 milliunits/min and increment of 4 millliunits/min) is associated with a shorter duration of first-stage of labor for all parities without increasing the cesarean delivery rate or adversely affecting perinatal outcomes."

High-dose oxytocin regimen for labor augmentation appears to be preferable on balance.

For the full abstract, click here.

Obstet Gynecol 118(2,Part 1):249-256, August 2011 © 2011 to the American College of Obstetricians and Gynecologists
Oxytocin Regimen for Labor Augmentation, Labor Progression, and Perinatal Outcomes. Jun Zhang, D. Ware Branch, Mildred M. Ramirez, et al.

Category: W. Pregnancy, Family Planning. Keywords: oxytocin, augmentation of labor, dosing regimen, perinatal outcomes, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 August 2011

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