Comparison of high and low doses of oxytocin protocols in multiparous pregnant women in terms of labor durations and fetal-maternal complications

Objective: Our aim is to compare high and low doses of oxytocin protocol applied during labor induction in terms of reliability and efficacy in multiparous pregnant women with Bishop score ≥6. Methods: Pregnant women between 37 and 41 weeks of gestation who had singleton and alive fetuses in vertex presentation, whose labor did not start spontaneously, who had no history of uterine surgery and no fetal congenital anomaly, who had Bishop score 6 and higher were included in this single center, randomized, prospective study with the indications of Category II trace, oligohydramnios and rational/psychosocial factor after obtaining their informed consent forms. A total of 164 multiparous pregnant women were separated into two groups during admission by simple randomization with opaque envelopes according to onset and increasing doses of oxytocin. In the groups which received low and high doses of oxytocin, labor durations, delivery types, newborn measurements, meconium presence, the presence of cord on neck, blood gas analyses, placental weights, maternal complications (postpartum bleeding, need for postpartum transfusion, puerperal fever, grades III–IV perineal lacerations and uterine rupture) and early newborn morbidity (respiratory distress, birth trauma, shoulder dystocia and neonatal hyperbilirubinemia) were compared. Results: When 75 pregnant women administered high doses of oxytocin and 75 pregnant women administered low doses of oxytocin were compared, no difference was observed between the groups in terms of the durations of phase I, phase II and phase III of labor, cesarean section rates, and maternal and perinatal complications (p>0.05). Although there was an increase in the rate of dark meconium by high dose induction protocol (p=0.01), the difference could not be established due to the limitations of the study in terms of intrapartum hypoxia which can be associated with 5-minute Apgar score being below 5 and acidemia in umbilical artery, pH being below 7, and base excess being 12 mmol/L and above. Conclusion: There is no difference between high or low doses of oxytocin induction in multiparous pregnant women in terms of labor duration, cesarean section rate, and maternal and perinatal complications.