Oxytocin augmentation in arrest disorders in the presence of thick meconium: influence on neonatal outcome.
The objective of this report was to study the effect of oxytocin augmentation in arrest disorders in the presence of thick meconium on meconium aspiration and fetal acidosis. We evaluated 3,321 singleton, term deliveries with cephalic presentation at our institution. Eight percent (253/3,321) had thick meconium in labor, and these patients comprised the study sample. Of the 253 women with thick meconium, 84 had an arrest disorder in the active phase of labor with normal fetal heart rate tracing at the time of diagnosis. Seventy-four percent (62/84) of the women with arrest were treated with oxytocin (group 1) and 26% (22/84) delivered by cesarean section without augmentation (group 2). There was a significant (p < 0.05) increase in the incidence of meconium aspiration (14.5 vs. 4.5%) and low (< 7.20) cord arterial pH (27.8 vs. 4.5%) in patients who received oxytocin compared to those who did not. Of the women who received oxytocin, 36 delivered vaginally, and 2 neonates had meconium aspiration. The remaining 26 women had cesarean sections following oxytocin augmentation and had a significantly higher (p < 0.05) frequency of meconium aspiration (26.9 vs. 4.5%) and low cord arterial pH (38.5 vs. 4.5%) compared to women who had cesarean sections without oxytocin augmentation. The findings suggest that oxytocin augmentation in arrest disorders in the presence of thick meconium may be associated with a higher risk of meconium aspiration and low umbilical cord arterial pH.
Morel
M I
MI
Albert Einstein College of Medicine, Department of Obstetrics and Gynecology, Bronx, NY.
Anyaegbunam
A M
AM
Mikhail
M S
MS
Legorreta
A
A
Whitty
J E
JE
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000453:epidemiology* / Q000209:etiology; D010121:Oxytocin / Q000009:adverse effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D014593:Uterine Inertia / Q000188:drug therapy*
D010121:Oxytocin