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A prospective study of high- versus low-dose oxytocin for induction of labor
A Hourvitz1, M Alcalay, J Korach
1Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Israel.
Background:
To assess the efficacy and safety of a high-dosage oxytocin induction regimen.
Methods:
A randomized prospective study of 179 patients who received an initial dose of either 2.5 (n = 98) or 1.25 (n = 81) mU/minute of oxytocin, with increments of 2.5 mU/minute or 1.25 at 30-minute intervals.
Results:
Failure rates (15.3% versus 19.8%), time to delivery, the number of assisted vaginal deliveries, cesarean sections, and maternal and fetal complications were not significantly different in the two protocols. However, the use of a high oxytocin dose resulted in significantly higher mean peak doses and increased total cumulative amounts. These were associated with a significant need to modify the oxytocin infusion protocol for hyperstimulation and fetal heart rate changes (65.1% versus 46.2%).
Conclusions:
Induction with higher dose oxytocin increments did not shorten time to delivery, but was associated with an increase in uterine hyperstimulation. Low-dose oxytocin was found to be appropriate and safe for labor induction.