1. Judicious Use of Oxytocin Augmentation for the Management of Prolonged Labor
- Author
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Elsa Lindtjørn, Jörn Schulz, T. B. Østborg, Torbjørn Moe Eggebø, and Janne Rossen
- Subjects
Adult ,medicine.medical_specialty ,Time Factors ,Cervical dilation ,Population ,Anal Canal ,Oxytocin ,Lacerations ,Fetal Distress ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,Pregnancy ,Oxytocics ,medicine.artery ,Fetal distress ,medicine ,Humans ,030212 general & internal medicine ,education ,Fetus ,education.field_of_study ,030219 obstetrics & reproductive medicine ,Labor, Obstetric ,Obstetrics ,Cesarean Section ,Norway ,business.industry ,Cephalic presentation ,Postpartum Hemorrhage ,Infant, Newborn ,Obstetrics and Gynecology ,Umbilical artery ,General Medicine ,Hydrogen-Ion Concentration ,Fetal Blood ,medicine.disease ,Dystocia ,Anesthesia ,Female ,Emergencies ,business ,Cohort study ,medicine.drug - Abstract
INTRODUCTION A protocol including judicious use of oxytocin augmentation was investigated to determine whether it would change how oxytocin was used and eventually influence labor and fetal outcomes. MATERIAL AND METHODS The population of this cohort study comprised 20 227 delivering women with singleton pregnancies ≥37 weeks, cephalic presentation, spontaneous or induced onset of labor, without previous cesarean section. Women delivering from 2009 to 2013 at Stavanger University Hospital, Norway, were included. Data were collected prospectively. Before implementing the protocol in 2010, oxytocin augmentation was used if progression of labor was perceived as slow. After implementation, oxytocin could only be started when the cervical dilation had crossed the 4-h action line in the partograph. RESULTS The overall use of oxytocin augmentation was significantly reduced from 34.9% to 23.1% (p < 0.01). The overall frequency of emergency cesarean sections decreased from 6.9% to 5.3% (p < 0.05) and the frequency of emergency cesarean sections performed due to fetal distress was reduced from 3.2% to 2.0% (p = 0.01). The rate of women with duration of labor over 12 h increased from 4.4% to 8.5% (p < 0.01) and more women experienced severe estimated postpartum hemorrhage (2.6% vs. 3.7%; p = 0.01). The frequency of children with pH
- Published
- 2017