Pulsatile oxytocin for induction of labor: a randomized prospective controlled study.
In a prospective randomized study, 20 patients with term pregnancies underwent induction of labor with either continuous or pulsed (every 8 minutes) intravenous oxytocin infusion. There were no significant differences with respect to induction-labor interval, induction-delivery interval, cesarean section rates, need for pain relief and Apgar scores. Sixty percent of patients receiving continuous oxytocin infusion developed uterine hyperstimulation but only 10% receiving pulsed oxytocin did so. However, the difference was not significant. The mean +/- SEM total amount of oxytocin given by continuous infusion was 4237 +/- 1066 mU which was 70% more than by pulsatile infusion (2454 +/- 808 mU). The highest rate of oxytocin infused was significantly lower by pulsatile administration (5.2 +/- 0.8 mU/min) than by continuous infusion (9.2 +/- 1.8 mU/min, p = less than 0.05). Our study demonstrates that pulsed administration of oxytocin every 8 minutes is as effective and safe as continuous intravenous infusion of oxytocin for induction of labor, requires less oxytocin with therefore, a wider margin of safety and is consistent with the pulsatile release of oxytocin during normal labor.
Odem
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Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.
Work
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Dawood
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D000293:Adolescent; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D007751:Labor, Induced / Q000379:methods*; D010121:Oxytocin / Q000008:administration & dosage*; D010865:Pilot Projects; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011446:Prospective Studies; D011897:Random Allocation
D010121:Oxytocin