Journal of perinatal medicine
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Randomized Controlled Trial Clinical Trial
Pulsatile oxytocin for induction of labor: a randomized prospective controlled study.
In a prospective randomized study, 20 patients with term pregnancies underwent induction of labor with either continuous or pulsed (every 8 minutes) intravenous oxytocin infusion. There were no significant differences with respect to induction-labor interval, induction-delivery interval, cesarean section rates, need for pain relief and Apgar scores. Sixty percent of patients receiving continuous oxytocin infusion developed uterine hyperstimulation but only 10% receiving pulsed oxytocin did so. ⋯ The mean +/- SEM total amount of oxytocin given by continuous infusion was 4237 +/- 1066 mU which was 70% more than by pulsatile infusion (2454 +/- 808 mU). The highest rate of oxytocin infused was significantly lower by pulsatile administration (5.2 +/- 0.8 mU/min) than by continuous infusion (9.2 +/- 1.8 mU/min, p = less than 0.05). Our study demonstrates that pulsed administration of oxytocin every 8 minutes is as effective and safe as continuous intravenous infusion of oxytocin for induction of labor, requires less oxytocin with therefore, a wider margin of safety and is consistent with the pulsatile release of oxytocin during normal labor.
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Two groups of 45 term, vaginally delivered infants were studied to determine effect of maternal intrapartum glucose therapy on neonatal blood glucose level at birth and at one and 2 hours of age. Twenty-three infants whose mother received glucose infusion prior to delivery (study group) had a significantly higher mean cord blood glucose level, lower 2 hour blood glucose levels and about three times higher incidence of hypoglycemia (glucose level less than or equal to 2.2 mmol/l) as compared to 22 infants whose mothers did not receive any glucose or fluid therapy. Neurobehavioral evaluation of the infants at 1 and 2 hour demonstrated, a significant association between hypoglycemia and a low muscle tone score and a delayed habituation to various stimuli. Blood glucose levels must be routinely monitored in infants whose mother receive glucose infusion prior to delivery to detect and treat early neonatal hypoglycemia.