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Labor dystocia and oxytocin augmentation before or after six centimeters cervical dilatation, in nulliparous women with spontaneous labor, in relation to mode of birth
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- Brüggemann, Cecilia (författare)
- Linköpings universitet,Medicinska fakulteten,Region Östergötland, Kvinnokliniken US
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- Carlhäll, Sara (författare)
- Linköpings universitet,Avdelningen för barns och kvinnors hälsa,Medicinska fakulteten,Region Östergötland, Kvinnokliniken US
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- Grundström, Hanna, 1982- (författare)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för omvårdnad och reproduktiv hälsa,Region Östergötland, Kvinnokliniken ViN
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- 2022-05-13
- 2022
- Engelska.
- Ingår i: BMC Pregnancy and Childbirth. - : BMC. - 1471-2393. ; 22:1
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- Background The effects of diagnosing and treating labor dystocia with oxytocin infusion at different cervical dilatations have not been fully evaluated. Therefore, we aimed to examine whether cervical dilatation at diagnosis of dystocia and initiation of oxytocin infusion at different stages of cervical dilatation were associated with mode of birth, obstetric complications and womens birthing experience. Methods A retrospective cohort study, including 588 nulliparous term women with spontaneous onset of labor and dystocia requiring oxytocin augmentation. The study population was divided into three groups according to cervical dilatation at diagnosis of dystocia and initiation of oxytocin-infusion (<= 5 cm, 6-10 cm, fully dilated) with mode of birth as the primary outcome. Secondary outcomes were obstetrical and neonatal complications and women s experience of childbirth. Statistical comparison between groups using Chi-square and ANOVA was performed. The risk of operative birth (cesarean section and instrumental birth) was assessed using binary logistic regression with suitable adjustments (maternal age, body mass index and risk assessment on admission to the labor ward). Results The cesarean section rate differed between the groups (p < 0.001); 12% in the <= 5 cm group, 6% in the 6-10 cm group and 0% in the fully dilated group. There was no increased risk for operative birth in the <= 5 cm group compared to the 6-10 cm group, adjusted OR 1.28 95%CI (0.78-2.08). The fully dilated group had a decreased risk of operative birth (adjusted OR 0.48 95%CI (0.27-0.85). The rate of a negative birthing experience was high in all groups (28.5%, 19% and 18%) but was only increased among women in the <= 5 cm group compared with the 6-10 cm group, adjusted OR 1.76 95%CI (1.05-2.95). Conclusions Although no difference in the risk of operative birth was found between the <= 5 cm and 6-10 cm cervical dilatation-groups, the cesarean section rate was highest in women with dystocia requiring oxytocin augmentation at <= 5 cm cervical dilatation. This might indicate that oxytocin augmentation before 6 cm cervical dilatation could be contra-productive in preventing cesarean sections. Further, the increased risk of negative birth experience in the <= 5 cm group should be kept in mind to improve labor care.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
Nyckelord
- Oxytocin augmentation; Active labor; Labor dystocia; Cesarean section; Birth experience
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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