A prospective study of high- versus low-dose oxytocin for induction of labor.
BACKGROUND
To assess the efficacy and safety of a high-dosage oxytocin induction regimen.


METHODS
A randomized prospective study of 179 patients who received an initial dose of either 2.5 (n = 98) or 1.25 (n = 81) mU/minute of oxytocin, with increments of 2.5 mU/minute or 1.25 at 30-minute intervals.


RESULTS
Failure rates (15.3% versus 19.8%), time to delivery, the number of assisted vaginal deliveries, cesarean sections, and maternal and fetal complications were not significantly different in the two protocols. However, the use of a high oxytocin dose resulted in significantly higher mean peak doses and increased total cumulative amounts. These were associated with a significant need to modify the oxytocin infusion protocol for hyperstimulation and fetal heart rate changes (65.1% versus 46.2%).


CONCLUSIONS
Induction with higher dose oxytocin increments did not shorten time to delivery, but was associated with an increase in uterine hyperstimulation. Low-dose oxytocin was found to be appropriate and safe for labor induction.
Hourvitz
A
A
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer and Sackler School of Medicine, Tel Aviv University, Israel.
Alcalay
M
M
Korach
J
J
Lusky
A
A
Barkai
G
G
Seidman
D S
DS
D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007751:Labor, Induced; D007743:Labor, Obstetric / Q000502:physiology; D007744:Obstetric Labor Complications; D010121:Oxytocin / Q000008:administration & dosage*; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D017211:Treatment Failure
D010121:Oxytocin