High Dose Oxytocin Versus Low Dose Oxytocin for Augmentation of Labor: A Prospective, Comparative, Randomized Study NVS Mahalakshmi Neerukonda1,*, More Shivraj1, Himabindu N2 1Department of Obstetrics and Gynecology, Rajiv Gandhi Government Women and Children Hospital, Pondicherry, India 2Department of Obstetrics and Gynecology, Indira Gandhi Medical College and Research Institute, Pondicherry, India *Corresponding e-mail: thallu.neerukonda@gmail.com
Online published on 19 November, 2018. Abstract Background Most common cause for delay in labor is due to inefficient uterine contractions. Various pharmacological interventions are available in shortening the duration of labor by augmentation making childbirth safe. One such drug is oxytocin being used for decades for shortening labor thus reducing maternal and neonatal morbidity. Objective To compare and estimate the efficacy and safety of high dose oxytocin with that of low dose oxytocin for augmentation of labor in terms of maternal and neonatal morbidity. Methods 400 women with singleton pregnancy, cephalic presentation, in spontaneous onset of labor at term in District hospital were randomized into 2 groups either low-dose (starting at 1 mU/min with incremental dose at 1–2 mU/min) or high dose augmentation groups (starting at 4 mU/min with incremental dose at 4 mU/min) until adequate contractions obtained. Labor duration, cesarean rates, maternal and neonatal complications, were calculated. Results Labor augmentation was significantly shorter by more than 2 hours in high dose oxytocin group than low dose group in nulliparas (2.83 ± 0.97 vs. 5.02 ± 1.43 hours, p<0.0001) and 1.6 hours in multiparas (2.05 ± 0.98 vs. 3.64 ± 1.08 hours, p<0.0001). No significant difference in the duration of second stage labor. The cesarean rates were not significantly different between the groups (4% vs. 5%, p=0.94). No difference in maternal and neonatal outcomes. Conclusion High dose oxytocin effectively reduces Oxytocin augmentation to delivery interval when compared to low dose group regardless of parity but more significantly in nulliparous than in multiparous with fewer complications. Top Keywords Labor dystocia, Oxytocin, Augmentation. Top |