Labor augmentation strategies: What's the evidence?

Labor augmentation is a commonly used strategy in obstetrics to make labor more efficient or to increase the chance of achieving a vaginal delivery. Intravenous infusion of synthetic oxytocin and early amniotomy are the most widely used methods, but there is considerable variation in how they are used in clinical practice. There remain significant differences in the timing, dosing, and administration of synthetic oxytocin across institutions. The use and timing of amniotomy is similarly controversial. Much of the clinical variation in augmentation practices stem from the significant heterogeneity that exists in the literature, as well as the lack of an optimal strategy that has been subjected to the scientific scrutiny needed to prove its superiority in both efficacy and safety. Further research is needed to allow for better standardized care of women presenting in spontaneous labor.