title: Oxytocin discontinuation after the active phase of labor is established.
abstract: Despite the widespread usage of oxytocin, there is still no consensus on its mode of administration. The scope of the present meta-analysis was to assess the effect of oxytocin discontinuation after the active phase of labor is established on maternal fetal and neonatal outcomes. We searched Medline, Scopus, Popline, ClinicalTrials.gov and Google Scholar databases. Eight studies were finally retrieved, which involved 1232 parturient. We observed significantly decreased rates of cesarean sections among parturient that discontinued oxytocin (OR 0.51, 95% CI 0.35, 0.74) as well as decreased rates of uterine hyperstimulation (OR 0.33, 95% CI 0.19, 0.58). Similarly, cases of non-reassuring fetal heart rates were fewer among women that did not receive oxytocin after the establishment of the active phase of labor (OR 0.63, 95% CI 0.41, 0.97). Keeping in mind the aforementioned maternal and neonatal adverse effects that seem to result from infusion of oxytocin until delivery, future practice should aim towards its discontinuation after the establishment of the active phase of labor, as it does not seem to influence the total duration of labor. Future studies should aim towards specific populations of parturient in order to clarify whether different approaches are needed.
authors.affiliation: a Department of Obstetrics and Gynecology , Athens University, Medical School, Alexandra Hospital , Athens , Greece.
authors.forename: Dimitrios-Efthymios G
authors.initials: DE
authors.lastname: Vlachos
authors.forename: Vasilios
authors.initials: V
authors.lastname: Pergialiotis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Papantoniou
authors.forename: Stamoulis
authors.initials: S
authors.lastname: Trompoukis
authors.forename: Georgios D
authors.initials: GD
authors.lastname: Vlachos
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric; D005260:Female; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000379:methods*; D007743:Labor, Obstetric; D016239:MEDLINE; D010120:Oxytocics / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D011256:Pregnancy Outcome; D014599:Uterus / Q000187:drug effects
chemical_list: D010120:Oxytocics; D010121:Oxytocin
keywords: Active; adverse; duration; fetal; labor; maternal; neonatal oxytocin