Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour

Abstract

For women making slow progress in spontaneous labour, treatment with oxytocin as compared with no treatment or delayed oxytocin treatment did not result in any discernable difference in the number of caesarean sections performed. In addition there were no detectable adverse effects for mother or baby. The use of oxytocin was associated with a reduction in the time to delivery of approximately two hours which might be important to some women. However, if the primary goal of this treatment is to reduce caesarean section rates, then doctors and midwives may have to look for alternative options.

Judicious use of oxytocin augmentation for the management of prolonged labor

“…Previous studies have documented that oxytocin augmentation is associated with a shorter duration of labor, which is in accordance with our findings . Childbirth satisfaction is an important health outcome and it may be desirable to avoid long labors .…”

“…The role of oxytocin in the management of labor is essential. Still, after 40 years of administration of the drug, its optimal timing and use is yet to be revealed .…”

Does Labor Augmentation with Oxytocin Increase the Risk of Postpartum Hemorrhage? A Randomized Controlled Trial

“…In 2013 a metaanalysis published on Cochrane library reviewed the effect of labor augmentation by oxytocin on the duration of first stage, fetal and maternal adverse effects and on the risk of conversion to cesarean section, they found that no significant effect on reduction of maternal and fetal adverse effects, conversion to cesarean section, but the was a significant effect on shortening of first stage [12]. Other previous clinical studies have reported an association between augmentation of labour and PPH.…”

Risk factors for nonreassuring fetal heart rate tracings after artificial rupture of membranes in spontaneous labor

“…Active management of labor is considered common practice by many institutions, as it has been reported to reduce the length of the first stage and the relative risk of prolonged labor, without affecting the rate of cesarean birth . In a Cochrane review, early artificial rupture of membranes (AROM) and oxytocin administration were further validated to shorten the duration of labor, with a modest reduction in the rate of cesarean birth over standard care …”