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High-dose versus lo...
High-dose versus low-dose of oxytocin for labour augmentation : a randomised controlled trial
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- Selin, Lotta (author)
- Univ Gothenburg, Sahlgrenska Acad, Inst Hlth & Care Sci, S-40530 Gothenburg, Sweden;NU Hosp Grp, Dept Obstet & Gynecol, Trollhattan, Sweden
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- Wennerholm, Ulla-Britt (author)
- Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynecol, Gothenburg, Sweden
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- Jonsson, Maria, 1966- (author)
- Uppsala universitet,Klinisk obstetrik
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- Dencker, Anna, 1956 (author)
- Gothenburg University,Göteborgs universitet,Centrum för personcentrerad vård vid Göteborgs universitet (GPCC),Institutionen för vårdvetenskap och hälsa,University of Gothenburg Centre for person-centred care (GPCC),Institute of Health and Care Sciences
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- Wallin, Gunnar (author)
- Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Obstet & Gynecol, Gothenburg, Sweden
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- Wiberg-Itzel, Eva (author)
- Karolinska Institutet
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- Almström, Elisabeth (author)
- NU Hosp Grp, Dept Obstet & Gynecol, Trollhattan, Sweden
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- Petzold, Max (author)
- Univ Gothenburg, Sahlgrenska Acad, Hlth Metr Unit, Gothenmurg, Sweden
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- Berg, Marie, 1955 (author)
- Gothenburg University,Göteborgs universitet,Centrum för personcentrerad vård vid Göteborgs universitet (GPCC),Institutionen för vårdvetenskap och hälsa,University of Gothenburg Centre for person-centred care (GPCC),Institute of Health and Care Sciences
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(creator_code:org_t)
- ELSEVIER, 2019
- 2019
- English.
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In: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 32:4, s. 356-363
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Abstract
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- Problem: Delayed labour progress is common in nulliparous women, often leading to caesarean section despite augmentation of labour with synthetic oxytocin.Background: High-or low-dose oxytocin can be used for augmentation of delayed labour, but evidence for promoting high-dose is weak.Aim: To ascertain the effect on caesarean section rate of high-dose versus low-dose oxytocin for augmentation of delayed labour in nulliparous women.Methods: Multicentre parallel double-blind randomised controlled trial (ClinicalTrials.gov: NCT01587625) in six labour wards in Sweden. Healthy nulliparous women at term with singleton cephalic fetal presentation, spontaneous labour onset, confirmed delay in labour and ruptured membranes (n = 1351) were randomised to labour augmentation with either high-dose (6.6 mU/minute) or low-dose (3.3 mU/minute) oxytocin infusion.Findings: 1295 women were included in intention-to-treat analysis (high-dose n = 647; low-dose n = 648). Caesarean section rates did not differ between groups (12.4% and 12.3%, 95% Confidence Interval -3.7 to 3.8). Women with high-dose oxytocin had: shorter labours (-23.4 min); more uterine tachysystole (43.2% versus 33.5%); similar rates of instrumental vaginal births, with more due to fetal distress (43.8% versus 22.7%) and fewer due to failure to progress (39.6% versus 58.8%). There were no differences in neonatal outcomes.Discussion: Our study could not confirm results of two systematic reviews indicating, with weak evidence, that use of high-dose oxytocin was associated with lower frequency of caesarean section.Conclusion: We found no advantages for routine use of high-dose oxytocin in the management of delay in labour. Low-dose oxytocin regimen is recommended to avoid unnecessary events of tachysystole and fetal distress.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Keyword
- Augmentation of labour
- Delayed labour
- Oxytocin
- Caesarean
- Nulliparous
Publication and Content Type
- ref (subject category)
- art (subject category)
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Selin, Lotta
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Wennerholm, Ulla ...
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Jonsson, Maria, ...
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Dencker, Anna, 1 ...
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Wallin, Gunnar
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Wiberg-Itzel, Ev ...
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Almström, Elisab ...
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Petzold, Max
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Berg, Marie, 195 ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Obstetrics Gynae ...
- Articles in the publication
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Women and Birth
- By the university
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Uppsala University
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Karolinska Institutet
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University of Gothenburg