Oxytocin does not reduce caesarean section rate

January 01, 0001

Oxytocin does not reduce caesarean section rate

Clinical Question: How effective is oxytocin for the treatment of slow progress in the first stage of spontaneous labour in low-risk women?

Bottom line: Oxytocin did not reduce the need for caesarean sections. It did not reduce the need for forceps deliveries or increase the number of normal deliveries when compared with no treatment or delayed oxytocin treatment. Oxytocin seemed to shorten labour by nearly two hours on average. The uptake of epidurals was no different. It did not seem to cause harm to the mother or baby.

Caveat: Early use of oxytocin resulted in an increase in uterine hyperstimulation associated with foetal heart changes. Sample size was too small to determine if its use had an effect on foetal mortality.

Context: Slow progress in the first stage of spontaneous labour is associated with an increased caesarean section rate and foetal and maternal morbidity. Oxytocin has long been advocated as a treatment for slow progress in labour but it is unclear to what extent it improves the outcomes for that labour and whether it actually reduces the caesarean section rate or maternal and foetal morbidity. Low risk referred to women with singleton pregnancies at term.

Cochrane Systematic Review: Bugg GJ et al. Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour. Cochrane Reviews, 2011, Issue 7. Article No. CD007123. DOI: 10.1002/14651858.CD007123.pub2. This review contains 8 studies involving 1338 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 326, September 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: W. Pregnancy, Family Planning. Keywords: oxytocin, labor, delivery, cesarean
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 15 November 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.