Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial
Objectives: To determine the outcome of early versus delayed Oxytocin augmentation in nulliparous women on the duration of labor and other obstetric and neonatal outcomes. Study Design:A prospective randomized trial. Place and Duration of study: The study was conducted at Pakistan Railways Hospital,...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Riphah International University, Islamabad
2011-07-01
|
| Series: | Journal of Islamic International Medical College |
| Subjects: | |
| Online Access: | https://journals.riphah.edu.pk/index.php/jiimc/article/view/793 |
| _version_ | 1798029491847561216 |
|---|---|
| author | Azra Saeed Awan, Umber Bakhtiar, Ghazala Amin |
| author_facet | Azra Saeed Awan, Umber Bakhtiar, Ghazala Amin |
| author_sort | Azra Saeed Awan, Umber Bakhtiar, Ghazala Amin |
| collection | DOAJ |
| description | Objectives: To determine the outcome of early versus delayed Oxytocin augmentation in nulliparous women on the duration of labor and other obstetric and neonatal outcomes.
Study Design:A prospective randomized trial.
Place and Duration of study: The study was conducted at Pakistan Railways Hospital, for the duration of 1 year with effect from January 2010 January, 2011. It is 400 bedded teaching hospital affiliated with IIMC-T of Riphah International University, Islamabad
Materials and Methods: In healthy nulliparous women with normal pregnancy,the progress of labor was thoroughly monitored and documented every 23 hours. If there was still no progress 1 hour after amniotomy, the woman was randomly allocated to either labor augmentation by oxytocin infusion or to postponement of oxytocin augmentation for 3 hours (expectant group, n = 158). Women whose labors had progressed satisfactory (1 cm/hour) after amniotomy were not randomized. Participants were managed according to a standard protocol entailing continuous documentation of the progress of labour, the amount of oxytocin administered, and obstetrical and neonatal outcomes. Oxytocin infusion was started at 6 mU/minute and was raised by 6 mU/minute every 30 minutes until efficient contractions were established in the early oxytocin group. In the expectant group, if no progress occurred after 3 hours, the women were reassessed regarding the need for oxytocin augmentation. Data were analyzed with SPSS 15.0. The MannWhitney U test was used to compare means. Proportions of events were compared with Fisher's exact test or chi-square analysis. Statistical significance was set at a Pvalue of <0.05.
Results: The caesarean section rate was 9% in the early oxytocin group and 10.7% in the expectant group (OR 0.8, 95% CI 0.51.4), and instrumental vaginal delivery 17% in the early oxytocin versus 12% in the expectant group (OR 1.5, 95% CI 0.972.4). Early initiation of oxytocin resulted in a mean decrease of 85 minutes in the randomization to delivery interval.
Conclusion: Early administration of oxytocin did not change the rate of caesarean section or instrumental
vaginal delivery but shortened labor duration significantly in women with a 2-hour arrest in cervical dilatation. No
other clear benefits or harms were seen between early and delayed administration of oxytocin. |
| first_indexed | 2024-04-11T19:25:04Z |
| format | Article |
| id | doaj.art-27f19f95d875435386600707ef501c98 |
| institution | Directory Open Access Journal |
| issn | 1815-4018 2410-5422 |
| language | English |
| last_indexed | 2024-04-11T19:25:04Z |
| publishDate | 2011-07-01 |
| publisher | Riphah International University, Islamabad |
| record_format | Article |
| series | Journal of Islamic International Medical College |
| spelling | doaj.art-27f19f95d875435386600707ef501c982022-12-22T04:07:09ZengRiphah International University, IslamabadJournal of Islamic International Medical College1815-40182410-54222011-07-016114191189Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled TrialAzra Saeed Awan, Umber Bakhtiar, Ghazala AminObjectives: To determine the outcome of early versus delayed Oxytocin augmentation in nulliparous women on the duration of labor and other obstetric and neonatal outcomes. Study Design:A prospective randomized trial. Place and Duration of study: The study was conducted at Pakistan Railways Hospital, for the duration of 1 year with effect from January 2010 January, 2011. It is 400 bedded teaching hospital affiliated with IIMC-T of Riphah International University, Islamabad Materials and Methods: In healthy nulliparous women with normal pregnancy,the progress of labor was thoroughly monitored and documented every 23 hours. If there was still no progress 1 hour after amniotomy, the woman was randomly allocated to either labor augmentation by oxytocin infusion or to postponement of oxytocin augmentation for 3 hours (expectant group, n = 158). Women whose labors had progressed satisfactory (1 cm/hour) after amniotomy were not randomized. Participants were managed according to a standard protocol entailing continuous documentation of the progress of labour, the amount of oxytocin administered, and obstetrical and neonatal outcomes. Oxytocin infusion was started at 6 mU/minute and was raised by 6 mU/minute every 30 minutes until efficient contractions were established in the early oxytocin group. In the expectant group, if no progress occurred after 3 hours, the women were reassessed regarding the need for oxytocin augmentation. Data were analyzed with SPSS 15.0. The MannWhitney U test was used to compare means. Proportions of events were compared with Fisher's exact test or chi-square analysis. Statistical significance was set at a Pvalue of <0.05. Results: The caesarean section rate was 9% in the early oxytocin group and 10.7% in the expectant group (OR 0.8, 95% CI 0.51.4), and instrumental vaginal delivery 17% in the early oxytocin versus 12% in the expectant group (OR 1.5, 95% CI 0.972.4). Early initiation of oxytocin resulted in a mean decrease of 85 minutes in the randomization to delivery interval. Conclusion: Early administration of oxytocin did not change the rate of caesarean section or instrumental vaginal delivery but shortened labor duration significantly in women with a 2-hour arrest in cervical dilatation. No other clear benefits or harms were seen between early and delayed administration of oxytocin.https://journals.riphah.edu.pk/index.php/jiimc/article/view/793oxytocin augmentation, prolonged labor, fetal distress. |
| spellingShingle | Azra Saeed Awan, Umber Bakhtiar, Ghazala Amin Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial Journal of Islamic International Medical College oxytocin augmentation, prolonged labor, fetal distress. |
| title | Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial |
| title_full | Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial |
| title_fullStr | Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial |
| title_full_unstemmed | Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial |
| title_short | Outcome of Early Versus Delayed Oxytocin Augmentation in Nulliparous Women on the Duration of Labour and other Obstetric and Neonatal Outcome - A Randomized Controlled Trial |
| title_sort | outcome of early versus delayed oxytocin augmentation in nulliparous women on the duration of labour and other obstetric and neonatal outcome a randomized controlled trial |
| topic | oxytocin augmentation, prolonged labor, fetal distress. |
| url | https://journals.riphah.edu.pk/index.php/jiimc/article/view/793 |
| work_keys_str_mv | AT azrasaeedawanumberbakhtiarghazalaamin outcomeofearlyversusdelayedoxytocinaugmentationinnulliparouswomenonthedurationoflabourandotherobstetricandneonataloutcomearandomizedcontrolledtrial |