• Acta Obstet Gynecol Scand · Jan 2009

    Use and abuse of oxytocin for augmentation of labor.

    • Lotta Selin, Elisabeth Almström, Gunnar Wallin, and Marie Berg.
    • Department of Obstetrics and Gynecology, NU Hospital Group, Trollhättan, Sweden. lotta.selin@vgregion.se
    • Acta Obstet Gynecol Scand. 2009 Jan 1;88(12):1352-7.

    ObjectiveTo investigate the use of oxytocin for augmentation of labor and its relation to labor progress and delivery outcome.Design And SettingA retrospective observational study undertaken in a Swedish hospital during 2000-2001.SampleSingleton pregnancies at > or = 37 weeks of gestation with cephalic presentation and spontaneous onset of labor.MethodsData were collected from 1,263 clinical records. The partogram was used to diagnose labor dystocia (LD).Main Outcome MeasuresPrevalence of oxytocin administration, LD and operative delivery.ResultsOxytocin 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.ConclusionsOxytocin 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.

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