Comparison of high dose oxytocin with low dose oxytocin in augmentation of delayed labour

Abstract

Background: Delay in the labour comprises the major factor leading to emergency intervention by caesarean section and is commonly seen in the nulliparous females. Despite the questionable efficacy of its use, as time passes, oxytocin use in labour has increased. Aims: the present clinical trial was carried out to assess the effect of high dose oxytocin against low dose oxytocin for augmentation of labour delayed on the rate of Caesarean section in nulliparous females. Methods: In 80 nulliparous females, spontaneous and instrumental vaginal births, labour duration, fever, hemorrhage, placenta removal, and sphincter injury, tachysystole, total duration of infusing oxytocin, maximum oxytocin dose, total oxytocin dose, and stoppage or reduction of oxytocin were assessed. Concerning neonatal outcomes, NICU (neonatal intensive care unit) admission and duration, metabolic acidosis, fetal distress, Apgar score of less than 4 or 7 at 5 minutes, and intrapartum thick meconium-stained amniotic fluid. The collected data were subjected to the statistical analysis and the results were formulated. The level of statistical significance was kept at the level of p < 0.05. Results: Caesarean sections were carried out in 80% (n=32) females in both low and high oxytocin groups. The main reason for C-section was the failure to progress to labour in both low oxytocin (62.5%, 25) and high oxytocin (55%, 22) groups with a non-statistical difference. Labour duration was short for the high oxytocin group (742±207) by 24 minutes. No difference was seen in the two groups concerning the fetal outcomes concerning any assessed parameter. A significantly lower dose was used in the low oxytocin group (5.72±5.56) than the high oxytocin group (7.96±8.31) with p<0001. Maximum oxytocin dose was also statistically higher low oxytocin group (p<0001). The observation of uterine tachysystoles was higher in the high dose oxytocin group (42.5%, 17) compared to the low dose (32.5%, 13). Conclusion: High oxytocin dose can be efficiently used in managing delayed labour to avoid adverse maternal or fetal outcomes with no difference in rates of caesarean section compared to low dose oxytocin used.