A trial of pulsatile versus continuous oxytocin administration for the induction of labor

The objective of this study was to compare the efficacy and complications of intermittently pulsed oxytocin administration with continuous infusion in the induction of labor. Patients undergoing scheduled induction of labor at term were randomized to a pulsatile group in which oxytocin was infused in boluses every 8 minutes or to a control group in which oxytocin was administered through a conventional continuous intravenous infusion. A total of 38 patients were studied. The groups were similar with respect to parity, gestational age, indication for induction, preinduction Bishop's score, and the use of prostaglandin gel for cervical ripening. The average induction-to-delivery interval was similar in both groups (14 hours). The frequency of uterine hyperstimulation was similar in both groups, as was the frequency of uterine of decreases in the rate of oxytocin infusion for any reason. The rate of cesarean delivery was similar (three in each group). The frequency of failed induction was similar with three in the pulsatile group and none in the continuous group. Pulsatile infusion of oxytocin was as efficacious as continuous infusion. However, it seems to offer no clinical advantage in this situation.