Oxytocin titration for induction of labour: a prospective randomized study of 15 versus 30 minute dose increment schedules.
Two hundred and twenty four patients admitted for induction of labour were randomized into 2 groups. The oxytocin dose was escalated every 15 minutes in the first group whilst for the second group the dose was increased every 30 minutes till optimal uterine activity was achieved. There was no significant difference in the mean maximum dose of oxytocin and length of labour in the 2 groups studied. Transient reduction of the dose of oxytocin was needed in 20.5% of patients in the '15 minute' group and 17.0% of cases in the '30 minute' group because of uterine hyperstimulation or fetal heart rate (FHR) changes; this difference was not statistically significant. The incidence of operative deliveries were similar in the 2 groups. The neonatal 1 and 5 minute Apgar scores, cord arterial blood pH, incidence of assisted ventilation and admission to the neonatal intensive care unit were similar in the 2 groups. The 15 minute schedule does not offer any advantage over the 30 minute escalation schedule for induction of labour. Hyperstimulation and FHR changes are a possibility with any regimen and close monitoring of FHR and uterine activity is advisable with the use of oxytocin.
Department of Obstetrics and Gynaecology, National University Hospital, Singapore.
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Chua
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Arulkumaran
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Kurup
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Tay
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Ratnam
D001034:Apgar Score; D001724:Birth Weight; D002985:Clinical Protocols / Q000592:standards*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006340:Heart Rate, Fetal; D006784:Hospitals, Teaching; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007363:Intensive Care Units, Neonatal; D007751:Labor, Induced / Q000379:methods*; D010121:Oxytocin / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D010343:Patient Admission / Q000706:statistics & numerical data; D011247:Pregnancy; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012846:Singapore
D010121:Oxytocin