Abstract
Objective:
To determine whether pulsatile oxytocin infusion improves delivery outcome in women requiring induction or augmentation of labor.
Study Design:
Two related randomized controlled trials undertaken in 2 inner-city United Kingdom university hospitals (ISRCTN72773405; http://www.isrctn.org/). Women were randomly assigned to a pulsatile or continuous infusion protocol. Primary outcome: cesarean section rate (induction trial); operative delivery rate (augmentation trial).
Results:
For induction, cesarean section rates were similar in women receiving pulsatile (n = 264, 38.3%) vs continuous infusion of oxytocin (n = 257; 37.7%; risk ratio, 1.01; 95% confidence interval, 0.81–1.26; P = .903), but associated with increased “infusion to time of delivery” intervals (P < .001) in the pulsatile group. For augmentation, pulsatile infusion resulted in higher operative delivery rates (70.1%, n = 251) vs continuous infusion (62.7%, n = 249; risk ratio, 1.12; 95% confidence interval, 0.99–1.27; P = .077) and increased neonatal morbidity.
Conclusion:
For induction, pulsatile infusion of oxytocin is effective, but conferred little clinical benefit. Pulsatile infusion is not recommended for augmentation.
To determine whether pulsatile oxytocin infusion improves delivery outcome in women requiring induction or augmentation of labor.
Study Design:
Two related randomized controlled trials undertaken in 2 inner-city United Kingdom university hospitals (ISRCTN72773405; http://www.isrctn.org/). Women were randomly assigned to a pulsatile or continuous infusion protocol. Primary outcome: cesarean section rate (induction trial); operative delivery rate (augmentation trial).
Results:
For induction, cesarean section rates were similar in women receiving pulsatile (n = 264, 38.3%) vs continuous infusion of oxytocin (n = 257; 37.7%; risk ratio, 1.01; 95% confidence interval, 0.81–1.26; P = .903), but associated with increased “infusion to time of delivery” intervals (P < .001) in the pulsatile group. For augmentation, pulsatile infusion resulted in higher operative delivery rates (70.1%, n = 251) vs continuous infusion (62.7%, n = 249; risk ratio, 1.12; 95% confidence interval, 0.99–1.27; P = .077) and increased neonatal morbidity.
Conclusion:
For induction, pulsatile infusion of oxytocin is effective, but conferred little clinical benefit. Pulsatile infusion is not recommended for augmentation.
| Original language | English |
|---|---|
| Pages (from-to) | 230.e1-230.e8 |
| Number of pages | 8 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 206 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Mar 2012 |
| Event | Perinatal Medicine Conference - Harrogate, ENGLAND Duration: 3 Jun 2008 → 5 Jun 2008 |
Keywords
- Adult
- Female
- Humans
- Infusions, Intravenous
- Labor, Induced
- Oxytocin
- Pregnancy
- Pregnancy Outcome
- Young Adult