Clinics in perinatology
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Synthetic oxytocin offers a safe and effective means of producing regular uterine activity and has a fairly large therapeutic index; however, the mild antidiuretic and vasoactive properties of oxytocin increase the risk of water intoxication and hypotension. The issue of reduction in cesarean section rates through the use of an active management protocol is being studied actively in the United States and Canada at this time. ⋯ The longer induction to delivery time demonstrated by some, but not all authors, in our opinion, is a reasonable alternative to avoidable uterine hyperstimulation with the potential for fetal and maternal injury. We advocate the use of the lowest dose necessary to produce adequate uterine contractility and cervical change.