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Continuation versus discontinuation of oxytocin infusion during the active phase of labour: a randomised controlled trial
Author(s) -
Bor P,
Ledertoug S,
Boie S,
Knoblauch NO,
Stornes I
Publication year - 2016
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.13589
Subject(s) - medicine , oxytocin , discontinuation , obstetrics , cervical dilation , randomized controlled trial , anesthesia , pregnancy , gynecology , surgery , gestation , biology , genetics
Objective To investigate whether discontinuation of oxytocin infusion increases the duration of the active phase of labour and reduces maternal and neonatal complications. Design Randomised controlled trial. Setting Department of O bstetrics and G ynaecology, R egional H ospital of R anders, D enmark. Population Women with singleton pregnancy in the vertex position undergoing labour induction or augmentation. Methods Two hundred women were randomised when cervical dilation was ≤4 cm to either continue or discontinue oxytocin infusion when cervical dilation reached 5 cm. Main outcome measures The primary outcome was duration of the active phase of labour, defined as the time period from 5 cm of cervical dilation until delivery. Secondary outcomes were mode of delivery, uterine tachysystole, hyperstimulation, abnormalities in fetal heart rate, postpartum haemorrhage rate, perineal tears, and neonatal outcomes. Results The active phase of labour was longer by 41 minutes (95% confidence interval 11–75 minutes) in the discontinued group (median 125 minutes in 85 women who had reached the active phase and delivered vaginally) versus the continued group (median 88 minutes in 78 women). The incidence of fetal heart rate abnormalities (51 versus 20%) and uterine hyperstimulation (12 versus 2%) was significantly greater in the continued than the discontinued oxytocin group. The incidence of tachysystole, caesarean deliveries, postpartum haemorrhage, third degree perineal tears and adverse neonatal outcomes was higher in the continued group, but did not reach significance. Conclusions Discontinuation of oxytocin infusion in the active phase of labour may improve some labour outcomes but has the disadvantage of increasing the duration of the active phase of labour. Tweetable abstract Stopping oxytocin in the active phase seems to make labour less complicated but lengthens duration.