Use and Abuse of Oxytocin for Augmentation of Labor

Selin, Lotta; Almström, Elisabeth; Wallin, Gunnar; Berg, Marie

doi:10.1097/01.aoa.0000397140.93642.d7

Cited by 19 publications

(33 citation statements)

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“…Another recent review found the entire concept of active management of labour to be associated with a slightly reduced risk of caesarean delivery 22. As in other studies, we found that approximately 50% of nulliparous women received oxytocin augmentation 16 17 23. There is reason to believe that guidelines for the diagnosis and treatment of protracted labour are unclear or inconsistently applied in daily practice 17.…”

Section: Discussionsupporting

confidence: 56%

Assessing the association of oxytocin augmentation with obstetric anal sphincter injury in nulliparous women: a population-based, case–control study

et al. 2014

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ObjectiveTo assess the association of oxytocin augmentation with obstetric anal sphincter injury among nulliparous women.DesignPopulation-based, case–control study.SettingPrimary and secondary teaching hospital serving a Norwegian region.Population15 476 nulliparous women with spontaneous start of labour, single cephalic presentation and gestation ≥37 weeks delivering vaginally between 1999 and 2012.MethodsBased on the presence or absence of oxytocin augmentation, episiotomy, operative vaginal delivery and birth weight (<4000 vs ≥4000 g), we modelled in logistic regression the best fit for prediction of anal sphincter injury. Within the modified model of main exposures, we tested for possible confounding, and interactions between maternal age, ethnicity, occiput posterior position and epidural analgaesia.Main outcome measureObstetric anal sphincter injury.ResultsOxytocin augmentation was associated with a higher OR of obstetric anal sphincter injuries in women giving spontaneous birth to infants weighing <4000 g (OR 1.8; 95% CI 1.5 to 2.2). Episiotomy was not associated with sphincter injuries in spontaneous births, but with a lower OR in operative vaginal deliveries. Spontaneous delivery of infants weighing ≥4000 g was associated with a threefold higher OR, and epidural analgaesia was associated with a 30% lower OR in comparison to no epidural analgaesia.ConclusionsOxytocin augmentation was associated with a higher OR of obstetric anal sphincter injuries during spontaneous deliveries of normal-size infants. We observed a considerable effect modification between the most important factors predicting anal sphincter injuries in the active second stage of labour.

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Section: Discussionsupporting

confidence: 56%

Assessing the association of oxytocin augmentation with obstetric anal sphincter injury in nulliparous women: a population-based, case–control study

et al. 2014

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“…Wide variations in its use between countries and hospitals may reflect the lack of structured guidelines . Labor augmentation with oxytocin is often administered without a clinical indication and unstructured use is common . Increased uterine activity may cause fetal distress and intense surveillance is needed in laboring women stimulated with oxytocin .…”

Section: Introductionmentioning

confidence: 99%

Judicious use of oxytocin augmentation for the management of prolonged labor

Rossen

Østborg

Lindtjørn

et al. 2015

Acta Obstet Gynecol Scand

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“…Several interventions were used in waterbirths in the present study. Oxytocin for augmentation of labor is used excessively in Sweden; 50–55% of all births with spontaneous onset are augmented, 20–35% of them without a diagnosis of labor dystocia . Labor dystocia was significantly more common in the NWBG (46 vs. 8), which could explain a greater use of oxytocin in this group.…”

Section: Discussionmentioning

confidence: 96%

“…In Sweden, almost all births take place at hospitals, although maternity care is provided to a large extent autonomously by midwives. There are no freestanding Birth Centers and the care is medically oriented with a frequent use of interventions . Until recently, planned waterbirths have only been found among the 70–75 home‐births/year.…”

Section: Introductionmentioning

confidence: 99%