Open AccessUse and abuse of oxytocin for augmentation of labor
Author(s) -
SELIN LOTTA,
ALMSTRÖM ELISABETH,
WALLIN GUNNAR,
BERG MARIE
Publication year - 2009
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016340903358812
Subject(s) - oxytocin , medicine , cephalic presentation , obstetrics , retrospective cohort study , gestation , labor induction , pregnancy , gynecology , surgery , biology , genetics
Objective. To investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome. Design and setting. A retrospective observational study undertaken in a Swedish hospital during 2000–2001. Sample. Singleton pregnancies at ≥ 37 weeks of gestation with cephalic presentation and spontaneous onset of labor. Methods. Data were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD). Main outcome measures . Prevalence of oxytocin administration, LD and operative delivery. Results. Oxytocin was administered to 55% of the women (75% of primiparas and 38.1% of multiparas); a majority did not meet LD criteria. LD frequency was 19.8% (32.7% in primiparas and 7.4% in multiparas). Oxytocin was started both ‘too early’ and ‘too late’ in relation to the diagnosis of LD. Cesarean section (CS) was performed on 17.1% of primiparous and 2.4% of multiparous oxytocin recipients with LD, compared to 2.3 and 1.5%, respectively, of oxytocin recipients without diagnosed LD. Conclusions. Oxytocin augmentation was undertaken in an unstructured manner; some women were inadequately treated and others were treated unnecessarily. Oxytocin recipients with LD underwent operative delivery to a higher extent than oxytocin recipients without LD, suggesting that the main reason for CS was the underlying problem of LD rather than the oxytocin augmentation itself.