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Obstet Gynecol. 1994 Feb;83(2):234-8.

High-dose oxytocin: 20- versus 40-minute dosage interval.

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1
Department of Obstetrics and Gynecology, Wilford Hall United States Air Force Medical Center, Lackland AFB, Texas.

Abstract

OBJECTIVE:

To determine whether an increase in the oxytocin dosing interval would decrease the incidence of uterine hyperstimulation.

METHODS:

This study included 1801 consecutive pregnancies receiving high-dose oxytocin. Oxytocin was used for labor augmentation in 1167 and induction in 634 women. Twenty- and 40-minute dosage intervals were compared. The study period was based on an 80% likelihood of detecting 5 and 10% differences in the cesarean and hyperstimulation rates, respectively. Statistics were analyzed with chi 2, Fisher, and Wilcoxon rank-sum tests where appropriate. Multivariate logistic regression and analysis of covariance were used to control for confounding demographic variables.

RESULTS:

Comparison of the 20- and 40-minute regimens for labor induction yielded no differences in the rates of cesarean delivery for dystocia (16 versus 19%) or fetal distress (5 versus 6%). The 20-minute regimen for augmentation was associated with a significant reduction in cesarean for dystocia (8 versus 12%; P = .05). The incidence of uterine hyperstimulation was greater with the 20-minute than the 40-minute regimen for induction (40 versus 31%; P = .02), but not for augmentation (31 versus 28%). Neonatal outcomes were unaffected by the dosage interval for both augmentation and induction.

CONCLUSION:

A 40-minute dosing interval for high-dose oxytocin offers no clear advantage over a 20-minute interval. Both regimens were safe and efficient, with no differences in perinatal outcome. The 20-minute interval was associated with fewer cesareans for dystocia when used for labor augmentation, whereas the 40-minute interval resulted in less hyperstimulation when used for labor induction.

PMID:
8290186
[Indexed for MEDLINE]
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